Hopp Faith, Woodbridge Peter, Subramanian Usha, Copeland Laurel, Smith David, Lowery Julie
HSR&D Center for Practice Management and Outcomes Research, VA Ann Arbor Health Care System, Ann Arbor, Michigan 48113, USA.
Telemed J E Health. 2006 Jun;12(3):297-307. doi: 10.1089/tmj.2006.12.297.
To determine whether adding telehealth technology to traditional home care services increases health-related quality of life (HRQOL) and home care satisfaction, and decreases resource utilization among home care patients. This trial included 37 home care patients receiving services in a Veterans Affairs medical center, randomized into intervention and control groups. Outcome measures included patient satisfaction and HRQOL at baseline and 6-month follow- up, and the use of inpatient and outpatient services before and during the 6-month study period. Intervention group patients reported greater improvement in the mental health component of HRQOL, (t = 2.27; df = 15; p = 0.04). Satisfaction with the telehealth equipment was high (means exceeded 4.0 on six measures ranging from 1-5). However, no statistically significant differences were observed between intervention and control groups in terms of changes in physical health, inpatient admissions, bed days of care, emergency department visits, or general satisfaction with home care services. Intervention group members did show a trend (p = 0.10) toward fewer overall outpatient visits (mean = 29.1; standard deviation [SD] +/- 30.1) compared to those receiving traditional home care services (mean = 38.9; SD +/- 28.9) The use of telehealth services as an adjunct to traditional home care is associated with greater improvements in mental health status and a trend toward lower use of inpatient and outpatient healthcare services. Further work, utilizing larger sample sizes, is needed to investigate the relationship between telehealth services, the use of healthcare resources, and other outcomes.
为了确定在传统家庭护理服务中添加远程医疗技术是否能提高与健康相关的生活质量（HRQOL）和家庭护理满意度，并减少家庭护理患者的资源利用。该试验纳入了37名在退伍军人事务医疗中心接受服务的家庭护理患者，随机分为干预组和对照组。结果指标包括基线时和6个月随访时的患者满意度和HRQOL，以及6个月研究期间之前和期间的住院和门诊服务使用情况。干预组患者报告HRQOL的心理健康成分有更大改善，（t = 2.27；自由度 = 15；p = 0.04）。对远程医疗设备的满意度很高（在1 - 5的六项指标上均值超过4.0）。然而，在身体健康变化、住院入院、护理天数、急诊就诊或对家庭护理服务的总体满意度方面，干预组和对照组之间未观察到统计学上的显著差异。与接受传统家庭护理服务的患者相比（均值 = 38.9；标准差[SD]±28.9），干预组成员在总体门诊就诊次数上确实呈现出减少的趋势（p = 0.10）（均值 = 29.1；标准差[SD]±30.1）。将远程医疗服务作为传统家庭护理的辅助手段与心理健康状况的更大改善以及住院和门诊医疗服务使用减少的趋势相关。需要利用更大样本量进行进一步研究，以调查远程医疗服务、医疗资源使用和其他结果之间的关系。
