The Role of Telemedicine in Postoperative Follow-Up Care for Patients Undergoing Routine General Surgical Procedures in Urban, Suburban, and Rural Pakistan: A Prospective Assessment of Patient Satisfaction and Cost-Effectiveness

Abstract

Objective: To prospectively assess the impact of telemedicine on patient satisfaction and cost-effectiveness compared to traditional face-to-face follow-up for routine general surgical procedures in Pakistan.

Study Design: Prospective randomized controlled trial, Multicenter study

Place and Duration of Study: This study was conducted at the Across Urban, Suburban, and Rural Tertiary Care Centers in Pakistan, between January and December 2024.

Methods: This trial enrolled 180 adult patients who underwent elective or emergency general surgical procedures (laparoscopic appendicectomy, laparoscopic cholecystectomy, and hernia repairs). Patients with complex histories or significant complications were excluded. Participants were randomized (1:1) to either a telemedicine follow-up group (n=90) or a face-to-face follow-up group (n=90). Primary outcomes were patient satisfaction and cost- effectiveness. Secondary outcomes included postoperative complications and time to return to normal activities.

Results: Baseline demographics were comparable. Satisfaction with surgical outcomes was high in both telemedicine (70%) and face-to-face (68%) groups (P = 0.751). Mean consultation time for telemedicine was
significantly shorter (8.6 min vs. 14.7 min, P < 0.001), contributing to cost savings by eliminating patient travel and minimizing time away from work. Non-attendance and complication rates were comparable. Rural patients in the telemedicine group reported higher satisfaction (P = 0.042), and video-based consultations led to higher satisfaction than phone-only (P = 0.049).

Conclusion: Telemedicine is a safe, efficient, and highly satisfactory alternative for routine postoperative surgical follow-up, particularly beneficial for rural patients and offering substantial time and cost savings, advocating for its wider integration.