학술논문
Examining Utilization of an Outpatient Telenutrition Service Across Primary Care Clinics in South Carolina.
Document Type
Academic Journal
Author
Gehring LN; College of Science Dean's Office, Clemson University, Clemson, South Carolina, USA.; Hales SB; Department of Psychiatry & Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA.; Kruis R; Center for Telehealth, Medical University of South Carolina, Charleston, South Carolina, USA.; Simpson K; Department of Healthcare Leadership & Management, Medical University of South Carolina, Charleston, South Carolina, USA.; Langston L; Center for Telehealth, Medical University of South Carolina, Charleston, South Carolina, USA.; McElligott J; Center for Telehealth, Medical University of South Carolina, Charleston, South Carolina, USA.
Source
Publisher: Mary Ann Liebert, Inc Country of Publication: United States NLM ID: 100959949 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3669 (Electronic) Linking ISSN: 15305627 NLM ISO Abbreviation: Telemed J E Health Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Limited research exists on outpatient telenutrition, and more evidence is needed on service utilization and program evaluation. This study explored service utilization trends and patterns of the Medical University of South Carolina (MUSC) Outpatient Telehealth Nutrition (OT Nutrition) service. Methods: De-identified patient service utilization data were obtained from MUSC's OT Nutrition administrative files (2012-2020). Service utilization (referrals, visits scheduled, consultations, no-shows, no-show rate) was measured at the clinic level and stratified by patient type (adult/pediatric) and clinic rurality (rural/urban). Data were analyzed using descriptive statistics and a K -means cluster analysis. Results: Service utilization (2012-2020) reflected 6,212 referrals, 3,993 visits scheduled, and 2,880 consultations across 56 clinics. Yearly utilization trends showed high variability with no statistically significant differences observed on univariate comparisons of patient type or clinic rurality. The introduction of the Direct-To-Consumer modality mitigated a 36.7% decrease in consultations during the COVID-19 pandemic in 2020. Results of a K -means cluster analysis ( p < 0.001) indicated 7% ( n = 4) of clinics were very high and high utilizers, 36% ( n = 21) were moderate and low utilizers, and 53% ( n = 31) were very low utilizers. Discussion: Telenutrition can be delivered effectively to patients without requiring travel outside patients' medical homes or residences. Although continued advocacy is necessary for South Carolina to expand telenutrition coverage, more research is needed to evaluate the OT Nutrition service. Cluster analysis is an effective tool for identifying statistically significant groupings of clinics based on service utilization and could be used with implementation science in future program evaluation.