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Dr. Alvarado-Livacic, Cristobal
Research Outputs
Contribution of a synchronic teleneurology program to decrease the patient number waiting for a first consultation and their waiting time in Chile
2020, Constanzo-Parra, Freddy, Aracena Sherck, Paula, Hidalgo, Juan Pablo, Peña, Lorena, Marrugo-Julio, Mery, González-Concha, Jonathan, Vergara, Gerardo, Alvarado-Livacic, Cristobal
Backround: There is a shortage of medical specialists in Chile, including neurologists; currently, there are 56,614 patients waiting for a first adult Neurology appointment in the country. The Teleneurology Program at the Hospital Las Higueras de Talcahuano (HHT) was implemented in 2015 to help reduce both the number of patients waiting for a first consultation and their waiting times. Methods: This retrospective study analyzed a cohort of 8269 patients referred to the HHT Neurology clinic between 2013 and 2018, from primary, secondary, and tertiary health centers. Cox regression analyses were performed to determine the factors influencing each outcome (number of patients waiting for a consultation and waiting time), such as age, gender, referral health establishment and the type of consultation (whether in situ at the HHT or by synchronic telepresence through the Teleneurology Program). Results: Out of the 8269 patients included in the study, 1743 consulted the neurologist through the Teleneurology Program, while 6526 received a consultation in situ at the HHT. Since its implementation (2015) until the end of 2018, the Teleneurology program contributed to decrease the number of patients waiting for their first appointment from 3084 to 298. Waiting time for the first consultation was 60% shorter for patients enrolled in the Teleneurology program than those with consultation in situ at HHT (6.23 ± 6.82 and 10.47 ± 8.70 months, respectively). Similar differences were observed when sorting patient data according to the referral health center. Cox regression analysis showed that patients waiting for a traditional in situ first adult Neurology consultation at the HHT had a higher risk (OR = 6.74) of waiting 90% longer than patients enrolled in the Teleneurology Program, without significant differences due to gender or age. Conclusions: Data from this study show a significant contribution of the Teleneurology Program at the HHT to decrease the number of patients waiting for a first consultation with a neurologist, as well as shorter waiting times, when derived from primary and secondary health centers.
Validation of a patient satisfaction survey of the Teleneurology program in Chile
2019, Constanzo-Parra, Freddy, Aracena Sherck, Paula, Hidalgo, Juan Pablo, Muñoz-Pareja, Maritza, Vergara, Gerardo, Alvarado-Livacic, Cristobal
Objective: Telemedicine arises as an attractive intervention for reducing the waiting time for appointments with medical specialists in Chile. Successful implementation of this technology requires safeguarding the patient/clinician trust relationship; however, no studies have been conducted to evaluate quality perception of a telemedicine program in Chile. To assess patient satisfaction with the Teleneurology program at the Hospital Higueras Talcahuano (HHT), addressing patient/clinician trust relationship. Results: A perception survey was constructed with 23 questions, distributed into 5 key areas (items) of user satisfaction. Its face validity was performed by five neurology specialists from the Teleneurology unit of HHT. The survey was applied to 167 patients of the HHT, recruited between 2018 and 2019, for conducting a pilot cross-sectional descriptive study to assess internal consistency (Cronbach alpha) and reliability (factorial analysis of main components). The survey showed an internal consistency of 0.88. Removing any of the items maintained its reliability in values over 0.8. All items showed point biserial correlations greater than 0.30. Overall, the survey constructed and evaluated in this study showed high internal consistency and reliability values, which will allow its application in further studies of quality assessment of the Teleneurology unit of HHT.
COVID-19 patient satisfaction and associated factors in telemedicine and hybrid system
2024, Dr. Alvarado-Livacic, Cristobal, Constanzo-Parra, Freddy, Gashaw, Dagmawit, Alemu, Zewdie, Belay, Feben, Tadesse, Yakob, Muñoz, Carla, Rojas, Juan
Background: The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. Methods: A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1–30), 2022, in Addis Ababa, Ethiopia. Results: The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. Conclusion: 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients’ clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient’s recovery.