Chumbler Neale R, Neugaard Britta, Ryan Patricia, Qin Haijing, Joo Yongsung
VA HSR&D/RR&D Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida 32608, USA.
J Telemed Telecare. 2005;11(3):150-6. doi: 10.1258/1357633053688723.
We assessed the utilization of health-care services and clinical outcomes in veterans with diabetes who were enrolled in two care coordination/home telehealth programmes. One group of patients was monitored weekly (n = 197), with more intensive evaluations, while the other was monitored daily (n = 100), but less intensively. Although patients in the two groups were fairly similar in demographic terms and in their clinical characteristics at baseline, they had different service utilization patterns during the 12-month pre-enrollment period. Over the 12-month study period, the proportion of one or more hospital admissions and number of bed days of care decreased in the daily monitoring group, and increased in the weekly monitoring group, more or less doubling in the former and being halved in the latter. Unscheduled primary care clinic visits were lower in the daily monitored group than in the weekly monitored group. The differences between the two groups were significant (P < 0.01). There were no significant differences between the groups in the clinical outcomes. Future research should employ randomized controlled trial designs to determine if intensities of home monitoring lead to differences in service utilization and health outcomes.
我们评估了参加两项护理协调/家庭远程医疗计划的糖尿病退伍军人的医疗服务利用情况和临床结局。一组患者每周接受监测（n = 197），评估更为密集，而另一组患者每天接受监测（n = 100），但评估强度较小。尽管两组患者在人口统计学特征和基线临床特征方面相当相似，但在入组前12个月期间，他们的服务利用模式有所不同。在为期12个月的研究期间，每日监测组的一次或多次住院比例和护理天数减少，而每周监测组则增加，前者或多或少翻倍，后者减半。每日监测组的非计划初级保健门诊就诊次数低于每周监测组。两组之间的差异具有统计学意义（P < 0.01）。两组在临床结局方面无显著差异。未来的研究应采用随机对照试验设计，以确定家庭监测强度是否会导致服务利用和健康结局的差异。
