Satisfaction of chronic patients with clinica! management by telemonitoring
DOI:
https://doi.org/10.36489/saudecoletiva.2021v11i69p8126-8140Keywords:
Health status, Disease management, Telemedicine, Patient satisfaction, Chronic diseaseAbstract
Objective: To identify the dimensions of the satisfaction of chronic patients with clinicai management by telemonitoring. Method: Cross-sectional study, from 2019, with 102 chronic patients of a health plan operator, in the Paraná-PR. Adults were included, independent for daily activities and who participated in this intervention for six to 12 months. Recorded telephone interviews were conducted with a questionnaire. Mann-Whitney U test and Poisson regression were used to analyze the data. Results: Most participants were satisfied with the intervention (97%), would recommend it (92%), would like to keep it (89,2%) and rated it as excellent (93%). Beneficiaries with less education were more satisfied with the professionals' technical knowledge (p = 0,045), their ability to explain (p = 0,004), the importance of clinicai management (p = 0,010) and general satisfaction with it (p = 0,028). There was an association between age, the quality of information given by the professional (p <0,001; PR= 0,505; CI = 0,70-0,66), quality of clinicai management (p <0,001; PR= 0,507; CI = 0,72-0,64) and general satisfaction with it (p <0,001; PR= 0,058; CI = O, 71-0,64). Conclusion: The dimensions of satisfaction identified explained the quality of health care for chronic patients at the time studied. Seen as satisfactory, clinical management by telemonitoring can be an option of assistance
change for greater sustainability of the health plan operator
References
Raghupathi W, Raghupathi V. An empirical study of chronic diseases in the United States: a visual analytics approach. lnt J Environ Res Public Health [Internet]. 2018 [Cited 2021 may 10]; 15(3):431. Available from: https:#pubmed.ncbi.nlm.nih. gov/29494555/. Dai: https:#doi.org/10.3390/ijerph15030431 2. Mendes, EV. O cuidado das condições crônicas na atenção primária à saúde: o imperativo da consolidação da estratégia da saúde da família. Available from: http:#bvsms.saude.gov.br/bvs/ publicacoes/cuidado_condicoes_atencao_primaria_saude.pdf. Brasília: Organização Pan-Americana da Saúde [Internet]. 2012 [Cited 2021 may 10]. 3. Paradise RK, Dryden E, Elvin D, Fisher C, Touw S, Trumble L, et ai. lncorporating patient input into the design of a disease management program for COPO. Healthcare [Internet]. 2019 [Cited 2021 may 10];1(8):100363. Available from: https:#europepmc. org/article/med/3114 7276. Dai: https:#doi.org/10.1016/j.hjdsi.2019.05.003. 4. Abdel-Wahab M, Rosenblatt E, Prajogi B, Zubizarretta E, Mikhail M. Opportunities in telemedicine, lessons learned after Covid-19 and the way into the future. Telemedicine [Internet]. 2020 [Cited 2021 may 10];108(2):438-43. Available from: https:#www.redjournal.org/action/showPdf7pii=S0360-3016%2820%2931402-4. Dai: https:#doi. org/10.1016/j.ijrobp.2020.07.006. 5. Ameh S, Gómez-Olivé FX, Kahn K, Tollman SM, Grobusch KK. Relationships between structure, process and outcome to assess quality of integrated chronic disease management in a rural South African setting: applying a structural equation model. BMC Health Serv Res [Internet]. 2017 [Cited 2021 may 10];17(1):229. Available from: https:#bmchealthservres.biomedcentral.com/ track/pdf/10.1186/s12913-017-2177-4.pdf. Dai: https:#doi. org/10.1186/s12913-017-2177-4. 6. Galbarro FJ P, Cruz CC, Arroyo AEG, Piedra CS. Satisfaction with healthcare services among patients with diabetes, hypertension, and/or dyslipidemia in México: a cross-sectional study. Value Health Reg lssues [Internet]. 2020 [Cited 2021 may 10];23(C):19-24. Available from: https:#www.valuehealthregionalissues.com/article/S2212-1099(19)30643-0/abstract. Dai: https:#doi.org/10.1016/j.vhri.2019.11.002. 7. Vainieri M, Quercioli C, Maccari M, Barsanti S, Murante AM. Reported experience of patients with single or multi pie chronic diseases: empirical evidence from ltaly. BMC Health Serv Res [Internet]. 2018 [Cited 2021 may 10];18:659. Available from: https:# bmchealthservres.biomedcentral.com/track/pdf/10.1186/ s12913-018-3431-0.pdf. Dai: https:#doi.org/10.1186/s12913- 018-3431-0. 8. Mármol-López MI, Montoya IM, Lozoya RM, Pérez AE, Caballero VG, Hontangas AR. Impacto de las intervenciones enfermeras en la atención a la cronicidad en Espafia. Revisión sistemática. Rev Esp Salud Publica [Internet]. 2018 [Cited 2021 may 10];92:e201806032. Available from: http:#scielo.isciii.es/ pdf/resp/v92/1135-5727-resp-92-e201806032.pdf. 9. Reynolds R, Dennis S, Hasan 1, Slewa J, Chen W, Tian D, Bobba S, Zwar N. A systematic review of chronic disease management interventions in primary care. BMC Fam Pract [Internet]. 2018 [Cited 2021 may 10];19(1 ):11. Available from: https:#bmcfampract.biomedcentral.com/track/pdf /10.1186/s12875-017- 0692-3.pdf. Dai: https:#doi.org/10.1186/s12875-017-0692-3. 10. Gonçalves-Bradley DC, J Maria AR, Ricci-Cabello 1, Villanueva G, Fonhus MS, Glenton C, et ai. Mobile technologies to support healthcare provider to healthcare provider communication and management of care. Cochrane Database Syst Rev [Internet]. 2020 [Cited 2021 may 10];8(8):CD012927. Available from: https:#www.cochranelibrary.com/cdsr/ doi/10.1002/14651858.CD012927.pub2/full. Dai: https:#dx. doi.org/10.1002%2F14651858.CD012927.pub2. 11. Ogata AJN. Promoção da saúde e prevenção de riscos e doenças na saúde suplementar brasileira: resultados do laboratório de inovação. Available from: https:#iris.paho.org/bitstream/handle/10665.2/49108/9789275718162-por.pdf?sequence= 1 &isAllowed=y. Brasília: Organização Panamericana da Saúde [Internet]. 2014 [Cited 2021 may 10]. 12. Unimed Guarapuava Cooperativa de Trabalho Medico [homepage]. Relatório de Gestão e Sustentabilidade 2015-2018. [Cited 17 nov 2020]. Available from: https:#www.unimed.coop.br/portalunimed/flipbook/guarapuava/relatorio_de_gestao_e_sustentabilidade_2015 _2018/ 13. Anderson EW, Fornell C, Lehmann DR. Customer satisfaction, market share, and profitability: findings from Sweden. J Mark [Internet]. 1994 [Cited 2021 may 10];58(3), 53-66. Available from: https:#journals.sagepub.com/ doi/10.1177 /002224299405800304. Dai: https:#doi. org/10.1177 /002224299405800304. 14. Reichheld FF. The one number you need to grow. Harvard Business Review. 2003;81 (12):46-57. [Cited 2020 Mar 10]. Available from: https:#marketinglowcost.typepad.com/files/ the-one-number-you-need-to-grow-1.pdf. 15. Santos MA, Sardinha AHL, Santos LN. Satisfação dos usuários com os cuidados dos enfermeiros. Rev Gaúcha Enferm [lnternet]. 2017 [Cited 2021 may 10]; 38(1):e57506. Available from: https://www.scielo.br/j/rgenf/a/TxTRGwffQcVtWVTsmXWLZbf/?lang=pt. Dai: https://doi.org/10.1590/1983- 144 7.2017.01.57506. 16. Treiman KA, Poit ST, Li L, Douglin MT, Gaines J, Hoerger T. Participant satisfaction and perceptions about program impact in the Medicaid Incentives for prevention of chronic disease pilot program. Am J Health Promot [Internet]. 2018 [Cited 2021 may 10];33(3):381-90. Available from: https://journals.sagepub. com/doi/abs/10.1177 /0890117118785351 ?journalCode=ahpa. Dai: https://doi.org/10.1177/0890117118785351. 17. Santana MJ, Feeny D. Framework to assess the effects of using patient-reported outcome measures in chronic care management. Qual Life Res [Internet]. 2014 [Cited 2021 may 10];23(5):1505-13. Available from: https://link.springer. com/article/10.1007 /s11136-013-0596-1. Dai: https://doi. org/10.1007 /s11136-013-0596-1. 18. Barbosa MIS, Bosi MLM. Vínculo: um conceito problemático no campo da Saúde Coletiva. Rev Saúde Coletiva [Internet]. 2017 [Cited 2021 may 10];27(4): 1003-22. Available from: https://www. scielo.br/j/physis/a/48VFbgflbRSh9tGJ7BzDSZq/?lang=pt. Dai: https://doi.org/10.1590/50103-73312017000400008. 19. Davisson, EA e Swanson, EA. Patient and nurse experiences in a rural chronic disease management program: a qualitative evaluation. Prof Case Manag [Internet]. 2018 [Cited 2021 may 10];23(1), 10-8. Available from: https://pubmed. ncbi.nlm.nih.gov/29176339/. Dai: http://dx.doi.org/10.1097 / NCM.0000000000000244. 20. Lima JA, Acuiia GS. Avaliação da qualidade de serviços através do modelo SERVQUAL: um estudo de caso em uma clínica médica da Cidade de Pau dos Ferros, Estado do Rio Grande do Norte, Brasil. Res Soe Dev [Internet]. 2020 [Cited 2021 may 10];9(8):e960986427. Available from: https://periodicos.utfpr.edu.br/revistagi/article/view/445. Dai: http://dx.doi. org/10.33448/rsd-v9i8.6427. 21. Reiners F, Sturm J, Bouw LJW, Wouters EJM. Sociodemographic factors influencing the use of eHealth in people with chronic diseases. lnt J Environ Res Public Health [Internet]. 2019 [Cited 2021 may 10];16(4):645. Available from: https://www. mdpi.com/1660-4601/16/4/645. Dai: https://doi.org/10.3390/ ijerph 16040645. 22. lftikhar S, Saqib A, Sarwar MR, Sarfraz M, Arafat M, Shoaib QU. Capacity and willingness to use information technology for managing chronic diseases among patients: A cross-sectional study in Lahore, Pakistan. PLoS One [Internet]. 2019 [Cited 2021 may 10];14(1):e0209654. Available from: https://pubmed.ncbi. nlm.nih.gov/30629632/. Dai: https://doi.org/10.1371 /journal. pone.0209654. 23. Kruse C, Fohn J, Wilson N, Nunez Patlan E, Zipp S, Mileski M. Utilization Barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review. JMIR Med lnform [Internet]. 2020 [Cited 2021 may 10];8(8):e20359. Available from: https://pubmed.ncbi.nlm.nih. gov/32784177 /. Dai: https://dx.doi.org/10.2196%2F20359. 8133 saúdecoletiva ■ 2021; (11) N.69 24. Vergara J, Parish A, Smallheer B. Telehealth: Opportunities in geriatric patient care during COVID-19. Geriatr Nurs [Internet]. No prelo. 2020 [Cited 2021 may 10]. Available from: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC7458119. Dai: https:// doi.org/10.1016/j.gerinurse.2020.08.D13. 25. Totten AM, Hansen RN, Wagner J, et ai. Telehealth for acute and chronic care consultations: comparative effectiveness review [Internet]. Rockville: Agency for Healthcare Research and Quality (US); 2019 [Cited 2020 Mar 10]. Available from: https:// europepmc.org/article/NBK/nbk54 7239. Dai: https://www.ncbi. nlm.nih.gov/books/NBK54 7239/. 26. Ministério da Saúde (BR). Diretrizes para o cuidado das pessoas com doenças crônicas nas redes de atenção à saúde e nas linhas de cuidado prioritárias. Available from: https://bvsms. saude.gov. br /bvs/pu bl icacoes/d i retrizes%20 _cuidada_ pessoas%20 _ doencas _ cronicas.pdf. Brasília: Ministério da Saúde, 2013 [Cited 2021 may 10]. 27. Agência Nacional de Saúde Suplementar (BR). Qualificação da Saúde Suplementar: uma nova perspectiva no processo de regulação. Available from: http://bvsms.saude.gov.br/bvs/publicacoes/qualificacao_saude_sup/pdf/completo.pdf. Rio de Janeiro: ANS, 2004 [Cited 2021 may 10]. 28. Christensen JKB. The emergence and unfolding of telemonitoring practices in different healthcare organizations. lnt J Environ Res Public Health [Internet]. 2018 [Cited 2020 Mar 10];15(1 ):61. Available from: https://www.mdpi.com/1660- 4601 /15/1 /61. Dai: https://doi.org/10.3390/ijerph15010061. 29. Sobrinho Segundo JPC. A satisfação do paciente como importante indicador de qualidade em saúde [Dissertação de mestrado]. Rio de Janeiro: Escola de Comando e Estado-Maior do Exército, 2018. xperiência. Saúde debate [online]. 2019, vol.43, n.123. 13. Kolling GJ; Silva MBB; Sá MCDNP. O Direito à Saúde no Sistema Prisional. v. 7 n. 1 (2013): Direito Sanitário. 14. Netto L, Silva KL, Rua MS. O processo de ensinar competências para promoção da saúde. Revista de Enfermagem do Centro-Oeste Mineiro. 2018.