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Evaluating the impact of a ‘virtual clinic’ on patient experience, personal and provider costs of care in urinary incontinence: A randomised controlled trial

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  • Georgina Jones
  • Victoria Brennan
  • Richard Jacques
  • Hilary Wood
  • Simon Dixon
  • Stephen Radley

Abstract

Objective: To evaluate the impact of using a ‘virtual clinic’ on patient experience and cost in the care of women with urinary incontinence. Materials and methods: Women, aged > 18 years referred to a urogynaecology unit were randomised to either (1) A Standard Clinic or (2) A Virtual Clinic. Both groups completed a validated, web-based interactive, patient-reported outome measure (ePAQ-Pelvic Floor), in advance of their appointment followed by either a telephone consultation (Virtual Clinic) or face-to-face consultation (Standard Care). The primary outcome was the mean ‘short-term outcome scale’ score on the Patient Experience Questionnaire (PEQ). Secondary Outcome Measures included the other domains of the PEQ (Communications, Emotions and Barriers), Client Satisfaction Questionnaire (CSQ), Short-Form 12 (SF-12), personal, societal and NHS costs. Results: 195 women were randomised: 98 received the intervention and 97 received standard care. The primary outcome showed a non-significant difference between the two study arms. No significant differences were also observed on the CSQ and SF-12. However, the intervention group showed significantly higher PEQ domain scores for Communications, Emotions and Barriers (including following adjustment for age and parity). Whilst standard care was overall more cost-effective, this was minimal (£38.04). The virtual clinic also significantly reduced consultation time (10.94 minutes, compared with a mean duration of 25.9 minutes respectively) and consultation costs compared to usual care (£31.75 versus £72.17 respectively), thus presenting potential cost-savings in out-patient management. Conclusions: The virtual clinical had no impact on the short-term dimension of the PEQ and overall was not as cost-effective as standard care, due to greater clinic re-attendances in this group. In the virtual clinic group, consultation times were briefer, communication experience was enhanced and personal costs lower. For medical conditions of a sensitive or intimate nature, a virtual clinic has potential to support patients to communicate with health professionals about their condition.

Suggested Citation

  • Georgina Jones & Victoria Brennan & Richard Jacques & Hilary Wood & Simon Dixon & Stephen Radley, 2018. "Evaluating the impact of a ‘virtual clinic’ on patient experience, personal and provider costs of care in urinary incontinence: A randomised controlled trial," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-16, January.
    • Handle: RePEc:plo:pone00:0189174
    DOI: 10.1371/journal.pone.0189174
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    References listed on IDEAS

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    1. Brazier, John & Ratcliffe, Julie & Salomon, Joshua & Tsuchiya, Aki, 2016. "Measuring and Valuing Health Benefits for Economic Evaluation," OUP Catalogue, Oxford University Press, edition 2, number 9780198725923.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    3. Don Husereau & Michael Drummond & Stavros Petrou & Chris Carswell & David Moher & Dan Greenberg & Federico Augustovski & Andrew Briggs & Josephine Mauskopf & Elizabeth Loder, 2013. "Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 367-372, June.
    4. Victoria Brennan & Simon Dixon, 2013. "Incorporating Process Utility into Quality Adjusted Life Years: A Systematic Review of Empirical Studies," PharmacoEconomics, Springer, vol. 31(8), pages 677-691, August.
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    1. Victoria K. Brennan & Georgina Jones & Stephen Radley & Simon Dixon, 2021. "Incorporating Process Utility into Cost-Effectiveness Analysis via a Bolt-On Domain to the SF-6D: An Exploratory Study," Applied Health Economics and Health Policy, Springer, vol. 19(5), pages 747-756, September.
    2. Daniel Rey Aldana & Francisco Reyes Santias & Pilar Mazón Ramos & Manuel Portela Romero & Sergio Cinza Sanjurjo & Belén Álvarez Álvarez & Rosa Agra Bermejo & Francisco Gude Sampedro & José R. González, 2021. "Cost and Potential Savings of Electronic Consultation and Its Relationship with Reduction in Atmospheric Pollution," Sustainability, MDPI, vol. 13(22), pages 1-16, November.
    3. Li Cao & Virasakdi Chongsuvivatwong & Edward B. McNeil, 2022. "The Association between mHealth App Use and Healthcare Satisfaction among Clients at Outpatient Clinics: A Cross-Sectional Study in Inner Mongolia, China," IJERPH, MDPI, vol. 19(11), pages 1-11, June.

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