慢性膝关节疼痛的第一手体验与远程康复的价值：一项嵌套于随机对照试验的离散选择实验。
完整摘要 · 中文译文
目的：本研究旨在评估通过远程康复接受物理治疗的第一手体验是否会影响患者对远程康复的偏好和支付意愿。设计：本研究采用嵌套于随机对照试验中的离散选择实验。方法：我们招募了319名45岁及以上的澳大利亚成年人，他们患有与骨关节炎一致的慢性膝关节疼痛，并已完成了一项临床试验，在试验中被随机分配接受通过远程康复或面对面进行的物理治疗。向参与者呈现假设情景，并要求他们在通过远程康复或面对面提供的物理治疗之间做出选择。每个情景呈现了不同水平的就诊的七个属性。数据采用广义多项logit模型和潜类别模型进行分析。结果：面对面试验组有164名参与者（占随机分组者的80%），远程康复组有155名参与者（占随机分组者的82%）参与了研究。远程康复组的参与者（即具有远程康复第一手体验者）相比面对面组的人群，愿意为远程康复就诊多支付87.49澳元（95%置信区间：72.83，102.14）（所有其他属性在分类变量中固定为参考值，在连续变量中固定为均值）。识别出四个亚组。在远程康复组中，105名（占155名的68%）参与者偏好远程康复，50名（32%）偏好面对面就诊。在面对面组中，63名（占1 64）强烈偏好面对面咨询，101人（61%）轻度偏好面对面咨询。结论：与接受面对面照护的人相比，有远程康复物理治疗亲身经历的人表现出更高的使用意愿和付费意愿。J Orthop Sports Phys Ther 2026;56(11):735-744. 电子版发布于2026年9月23日。doi:10.2519/jospt.2026.14073。
完整摘要 · 英文原文
OBJECTIVE: The aim of this study was to assess whether first-hand experience of receiving physical therapy via telerehabilitation affected patient preferences and willingness to pay for telerehabilitation. DESIGN: This study used a discrete choice experiment nested within a randomized controlled trial. METHODS: We recruited 319 Australian adults aged 45 years or over, with chronic knee pain consistent with osteoarthritis, who had completed a clinical trial where they were randomized to receive physical therapy via telerehabilitation or in-person. Participants were presented hypothetical scenarios and asked to choose between physical therapy delivered via telerehabilitation or in-person. Each scenario presented seven attributes of consultations at varying levels. Data were analyzed using a generalized multinomial logit and latent class models. RESULTS: There were 164 participants from the in-person trial arm (80% of those randomized) and 155 from the telerehabilitation arm (82% of those randomized) who participated. Participants in the telerehabilitation arm (ie, with first-hand experience of telerehabilitation) were willing to pay AU$ 87.49 (95% confidence interval: 72.83, 102.14) more than people in the in-person arm for telerehabilitation consultations (all other attributes fixed at reference values for categorical variables and at mean values for continuous variables). Four subgroups were identified. In the telerehabilitation arm, 105 (68% of 155) participants preferred telerehabilitation, and 50 (32%) preferred in-person consultations. In the in-person arm, 63 (39% of 164) held a strong preference for in-person consultations, and 101 (61%) had a mild preference for in-person consultations. CONCLUSION: People with first-hand experience using telerehabilitation for physical therapy expressed a greater willingness to use and pay for it than people who experienced in-person care. J Orthop Sports Phys Ther 2026;56(11):735-744. Epub 23 September 2026. doi:10.2519/jospt.2026.14073.