Pediatric Urology Division, Arkansas Children's Hospital, Little Rock, Arkansas, USA University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
Pediatric Urology Division, Arkansas Children's Hospital, Little Rock, Arkansas, USA University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
J Telemed Telecare. 2014 Dec;20(8):427-30. doi: 10.1177/1357633X14555610. Epub 2014 Oct 14.
We conducted a retrospective study of paediatric urological surgery patients over a 12-month period. We compared patients followed up by telemedicine with those who had post-operative follow-up on site at the Arkansas Children's Hospital (ACH) in Little Rock. All pre-operative patients living in northwest Arkansas were given the opportunity to use telemedicine from a satellite clinic at Lowell, 328 km from the hospital. Of 61 patients, 10 chose telemedicine and 51 chose to be evaluated at the ACH clinic. All telemedicine visits were completed successfully, but in four cases, the video clarity of the telemedicine images was not sufficient for decision-making, and a digital photograph was sent by email to the physician at the ACH. There were no post-operative surgical complications in either patient group. In the telemedicine group, the median distance to the ACH was 330 km, and the median distance to the remote clinic was 35 km. In the on-site group, the median distance to the ACH was 293 km, which was significantly less (P=0.03). In the on-site group, the median travel time to the ACH was 174 min. If the telemedicine group had driven to the hospital, the median travel time would have been 192 min. Logistic regression showed that for every 37 km increase in distance to ACH, patients had a 111% increase in the odds of receiving telemedicine compared to receiving on-site care (OR=2.1, 95% CI: 1.0, 4.4). The pilot study supports the use of telemedicine for the post-operative evaluation of paediatric urology surgery patients and suggests that substantial travel distance and time savings can be made.
我们对为期 12 个月的小儿泌尿科手术患者进行了回顾性研究。我们比较了通过远程医疗进行随访的患者和在小石城阿肯色儿童医院（ACH）进行术后随访的患者。所有居住在阿肯色州西北部的术前患者都有机会从距离医院 328 公里的洛厄尔卫星诊所使用远程医疗。在 61 名患者中，有 10 名选择远程医疗，51 名选择在 ACH 诊所接受评估。所有远程医疗访问都成功完成，但在 4 例情况下，远程医疗图像的视频清晰度不足以做出决策，因此通过电子邮件将数字照片发送给 ACH 的医生。两组患者均无术后手术并发症。在远程医疗组中，到 ACH 的中位数距离为 330 公里，到远程诊所的中位数距离为 35 公里。在现场组中，到 ACH 的中位数距离为 293 公里，明显更近（P=0.03）。在现场组中，到 ACH 的平均旅行时间为 174 分钟。如果远程医疗组开车去医院，平均旅行时间将为 192 分钟。逻辑回归显示，与接受现场护理相比，ACH 距离每增加 37 公里，患者接受远程医疗的几率就会增加 111%（OR=2.1，95%CI：1.0，4.4）。试点研究支持使用远程医疗对小儿泌尿科手术患者进行术后评估，并表明可以节省大量的旅行距离和时间。
