VA Rehabilitation Outcomes Research Center (151B), 1601 SW Archer Road, Gainesville, FL 32608-1197, USA.
J Telemed Telecare. 2011;17(3):123-6. doi: 10.1258/jtt.2010.100314. Epub 2010 Dec 16.
We assessed the effects of a care coordination home-telehealth (CCHT) programme on health service utilization. The subjects (n = 387 for each group) were US veterans diagnosed with diabetes and followed for 48 months. The service utilization measures were numbers of all-cause inpatient stays and outpatient visits during the follow-up period. We used generalized linear mixed models to estimate the adjusted effects of the CCHT programme on service use over time. Compared with the controls, the CCHT clients were less likely to be admitted for inpatient care during the first (P < 0.001) and second (P < 0.01) six-month follow-up period, and were consistently more likely to visit outpatient clinics (P < 0.001) during the whole 48-month follow-up period. The likelihood of increase in outpatient utilization tended to decline over time. The findings suggest that the CCHT programme helped to reduce overall inpatient and outpatient use by the clients over the 48-month follow-up period.
我们评估了一种家庭远程医疗护理协调（CCHT）计划对卫生服务利用的影响。研究对象（每组 387 人）为被诊断患有糖尿病的美国退伍军人，随访时间为 48 个月。服务利用的衡量指标为随访期间所有原因的住院人数和门诊就诊次数。我们使用广义线性混合模型来估计 CCHT 计划对服务使用的调整后影响随时间的变化。与对照组相比，CCHT 组在第一个（P < 0.001）和第二个（P < 0.01）六个月的随访期间，住院治疗的可能性较小，在整个 48 个月的随访期间，门诊就诊的可能性持续较大（P < 0.001）。门诊利用率增加的可能性随时间呈下降趋势。研究结果表明，在 48 个月的随访期间，CCHT 计划有助于减少患者的总体住院和门诊使用。
