A survey of bacillary dysentery in a rural community in Serbia

The findings from an epidemiological survey of bacillary dysentery in three villages in south-west Serbia are reported. Factors in the transmission of infection—in particular, living conditions and standards of hygiene—are discussed, and an attempt is made to assess the value of various popular remedies, such as herbal decoctions, and the diet generally followed. Data are given on the bacteriological examination of faecal cultures; the results of sulfonamide and serum therapy are described.     

A feasibility study of realtime telemedicine in Croatia using Internet videoconferencing

We explored the feasibility of realtime telemedicine in Croatia using Internet videoconferencing. A 33 kbit/s link was established between a team of specialists in the General Hospital 'Sveti Duh' in Zagreb and a general practitioner's clinic in Selca, on the island of Brac. During a two-week study, 16 patients (median age 51 years) were studied. Twenty-one teleconsultations (seven initial and 14 follow-up visits) were conducted, 13 with a specialist in internal medicine, six with a surgeon and two with a neurologist. In 18 cases (86%) telemedicine successfully replaced hands-on examination. The mean duration of the teleconsultations was 7.2 min (initial visits 7.4 min, follow-up visits 7.1 min). Each computer system cost about US$700. The total connection cost for the study was US$4.95. The teleconsultations saved the patients US$272 in travel costs. We suggest forming a permanent on-line specialist service connected to networked clinics via the Internet to improve access to health-care in Croatia.     

Patient and physician satisfaction in a clinical study of telemedicine in a hypertensive patient population

We studied patient and physician satisfaction with telemedicine for the care of a hypertensive population. Once recruited, participants were seen both in person and via telemedicine (in random order) on the same day. After each meeting, patient and physician satisfaction surveys were completed. In the 12-month study, there were 107 pairs of visits. The physicians reported a small but significant increase in workload, mental effort, technical skills and visit duration for telemedicine when compared with face-to-face consultations. They noted that the telemedicine system worked well in the majority of cases and could reduce the need for future treatment. Patients reported slightly but significantly higher satisfaction scores for the following for in-person than for telemedicine meetings: technical quality, interpersonal care and time spent. Patients reported high satisfaction scores for both telemedicine and in-person visits.     

User satisfaction with a telemedicine amputee clinic in Saskatchewan

A group of 15 patients with amputee-related diagnoses were given a satisfaction survey after telemedicine assessment. Most of the videoconferencing sessions used an IP connection at 768 kbit/s. The patients were seen at four sites. The average connection time was less than 5 min and the average time for a session was approximately 40 min. Thirteen questions required scaled responses (poor, fair, good, excellent) and two required yes/no answers. The 13 categories broadly related to satisfaction with the telemedicine service and the quality of specialist care. In all categories, 97% of the responses fell in the good to excellent range. Concerns were raised about ease of access to local telemedicine sites, connection waiting times and lack of familiarity with telemedicine technology. The study showed that telemedicine was acceptable to patients with amputations and provided a reliable assessment of the amputee.     

Patient satisfaction with telemedicine in a prison environment.

Prison inmates were surveyed about their perceptions of the use of videoconferencing in clinical consultations. A 14-item questionnaire was used to assess satisfaction with the patient-physician clinical interaction. Of the 299 inmates surveyed immediately after their teleconsultations, 221 completed questionnaires that were suitable for analysis (74%). Only 9% of patients indicated that they were not satisfied with the teleconsultation. They rated the telemedicine context well above the midpoint of the scale (16) on both an information-exchange and a patient-comfort dimension, with means of 29 and 24, respectively. There was a significant difference (P < 0.01) in the patient-comfort dimension in terms of the location of the prisoners. No significant differences were found in patient satisfaction related to the specialty of the physician. The results suggest that many contextual factors must be considered to understand the communicative implications of patient satisfaction with telemedicine.     

A survey of patient and family satisfaction with social work services

Client satisfaction can be important indicator of the quality of social work services. This article reports the results of a survey conducted by a social work department of a large urban teaching hospital to elicit patient and family reaction to its services. A random, proportionate sample of in- and out-patient cases in medical and psychiatric programs was used. In general, staff was seen as helpful, although with interesting variations depending on the social work function performed. The findings have implications for education, supervision, quality assurance, levels of staffing and staff's perception of their usefulness.     

Development of the Telemedicine Satisfaction Questionnaire to evaluate patient satisfaction with telemedicine: a preliminary study

We developed a questionnaire for the evaluation of patient satisfaction with telemedicine. Items related to patient satisfaction with telemedicine were identified through a review of the literature. The internal consistency and the intraclass correlation coefficient were used to evaluate the reliability of the proposed instrument. Content validity was examined using a panel of experts. The predictive validity of the proposed instrument was assessed by correlating scores on the Telemedicine Satisfaction Questionnaire (TSQ) with haemoglobin A(1c) levels and adherence to self-management activities among 38 patients with type 2 diabetes, after they had completed a four-session interactive diabetes tele-education programme. A principal-components analysis with varimax rotation was performed to reduce the number of questionnaire items from 15 to 14, and the scree test was used to select significant factors. There were three components with eigenvalues over 1.0, which together explained 68% of the total variance. These were: quality of care provided, similarity to face-to-face encounter and perception of the interaction. The TSQ demonstrated preliminary reliability and validity but more extensive testing will be required before it can be considered generally applicable.     

Mexican patient satisfaction in a rural Minnesota primary care clinic

The Latino population in rural Minnesota has grown significantly in recent years. Despite the increase, few studies have considered whether these newcomers are satisfied with the care they receive from local medical clinics. This article describes the results of a pilot study that assessed 20 Mexican patients' satisfaction with care they received in a primary care clinic in rural central Minnesota. Participants were interviewed using questions from Stewart's Interpersonal Care Survey and open-ended questions. Results showed the patients were generally satisfied with their health care. However, they suggested improvements in the areas of communication and involvement in decisions. Answers to the open-ended questions suggested that even though patients seemed satisfied with their care, they still strongly desired a bilingual physician.     

浙江省德清县农村社区成人卫生服务利用状况调查

采用流行病学现况研究设计,整群抽取浙江省德清县4个农村社区,面对面调查6068名18—64周岁的社区户籍居民,以了解德清农村社区成人居民卫生服务利用情况。结果提示转型期农村社区居民的有效卫生需求未得到合理满足,目前的新农合制度有待于完善。     

A survey of Norwegian telemedicine.

To get an overview of Norwegian telemedicine, a questionnaire was sent to the contact persons of telemedicine programmes. There was an 83% response rate from 102 telemedicine programmes; there were 66 active research projects. Several larger networks had recently started operation, probably as a result of the Ministry of Health and Social Affairs' plan of action on information and communication technology in health care. Twenty-one programmes involved primary care or home care. Few programmes were using telemedicine to bridge established divisions of service responsibility or to make connections to institutions abroad. There were three large national research programmes in which telemedicine played an important role. Research projects were evaluating the economic, organizational and sociological aspects of telemedicine, as well as the medical. The oldest telemedicine activities were in northern Norway.     

Obtaining information on patient satisfaction with hospital care: mail versus telephone.

Many objectives of the study examined here were to develop a questionnaire useful in eliciting the perceptions of patients regarding their hospital care, to compare the methodologic and substantive differences between a mail survey and a telephone survey of patients done approximately a week post discharge, and to develop methods allowing the questionnaire to be administered by an organization other than the hospital. Two independent surveys were conducted at the same hospital--a telephone survey with a telephone follow-up, and a mail survey with a telephone follow-up. The study demonstrated that an organization external to the hospital can economically conduct a patient satisfaction survey of a representative patient sample while ensuring confidentiality and producing potentially useful results. The mail survey was preferred over the telephone survey due to lower cost, lower chance of biased responses, and complete assurance of confidentiality. The aspects of hospital care most influencing patient satisfaction related to nursing services.     

Technology and managed care: patient benefits of telemedicine in a rural health care network

Rural health providers have looked to telemedicine as a technology to reduce costs. However, virtual access to physicians and specialists may alter patients' demand for face-to-face physician access. We develop a model of service demand under managed care, and apply the model to a telemedicine application in rural Alaska. Provider-imposed delays and patient costs were highly significant predictors of patient contingent choices in a survey of ENT clinic patients. The results suggest that telemedicine increased estimated patient benefits by about $40 per visit, and reduced patients' loss from rationing of access to physicians by about 20%.