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脊髓损伤/疾病远程会诊结果研究。

Spinal cord injury/disorder teleconsultation outcome study.

作者信息

Young-Hughes Sadie, Simbartl Loretta A

机构信息

Cincinnati Veterans Affairs Medical Center, Spinal Cord Injury/Disorder Clinic, OH, USA.

出版信息

Rehabil Nurs. 2011 Jul-Aug;36(4):153-8, 172. doi: 10.1002/j.2048-7940.2011.tb00083.x.

Abstract

The purpose of this study was to compare the costs of providing specialty wound care to spinal cord injury/disorder (SCI/D) veterans by teleconsultation and traditional care. A retrospective design was used to conduct this descriptive, correlational study. A convenience sample of 76 SCI/D veterans (2 women, 74 men) met inclusion criteria from a possible 123 subjects. Variables were compared between groups using nonparametric methods (Wilcoxon rank sums and chi-square). There was no significant difference in inpatient admissions or inpatient bed days of care between the two groups. The teleconsultation group had more outpatient encounters (medians 12 vs. 4, p = .007; Wilcoxon statistic = 412.5) and longer inpatient stays (medians 81 vs. 19 days/admission, p = .05; Wilcoxon statistic = 227.0) compared to the traditional care group. There was no significant difference in inpatient cost between the two groups; however, the teleconsultation group had a significantly higher median cost per outpatient encounter ($440 vs. $141, p <.0001; Wilcoxon statistic = 469.0). Although this study only looked at costs directly associated with wound management, continued research exploring the use of teleconsultation in other areas of SCI/D specialty is needed to enhance its application.

摘要

本研究的目的是比较通过远程会诊和传统护理为脊髓损伤/疾病(SCI/D)退伍军人提供专科伤口护理的成本。采用回顾性设计进行这项描述性、相关性研究。从可能的123名受试者中选取了76名符合纳入标准的SCI/D退伍军人作为便利样本(2名女性,74名男性)。使用非参数方法(Wilcoxon秩和检验和卡方检验)对两组之间的变量进行比较。两组之间的住院次数或住院护理天数没有显著差异。与传统护理组相比,远程会诊组有更多的门诊就诊次数(中位数分别为12次和4次,p = 0.007;Wilcoxon统计量 = 412.5)和更长的住院时间(中位数分别为81天和19天/次入院,p = 0.05;Wilcoxon统计量 = 227.0)。两组之间的住院费用没有显著差异;然而,远程会诊组每次门诊就诊的中位数费用显著更高(440美元对141美元,p < 0.0001;Wilcoxon统计量 = 469.0)。尽管本研究仅关注与伤口管理直接相关的成本,但仍需要继续开展研究,探索在SCI/D专科的其他领域使用远程会诊,以扩大其应用范围。

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