McKissick Holly D, Cady Rhonda G, Looman Wendy S, Finkelstein Stanley M
J Pediatr Health Care. 2017 Jul-Aug;31(4):452-458. doi: 10.1016/j.pedhc.2016.11.006. Epub 2016 Dec 22.
The purpose of this analysis was to evaluate the effects of an advanced practice nurse-delivered telehealth intervention on health care use by children with medical complexity (CMC). Because CMC account for a large share of health care use costs, finding effective ways to care for them is an important challenge requiring exploration.
This was a secondary analysis of data from a randomized clinical trial with a control group and two intervention groups. The focus of the analysis was planned and unplanned clinical and therapy visits by CMC over a 30-month data collection period. Nonparametric tests were used to compare visit counts among and within the three groups.
The number of unplanned visits decreased over time across all groups, with the greatest decrease in the video telehealth intervention group. Planned visits were higher in the video telehealth group across all time periods.
Advanced practice registered nurse-delivered telehealth care coordination may support a shift from unplanned to planned health care service use among CMC.
本分析的目的是评估由高级执业护士提供的远程医疗干预对患有复杂疾病的儿童（CMC）医疗保健使用情况的影响。由于患有复杂疾病的儿童占医疗保健使用成本的很大一部分，因此找到有效的护理方法是一项需要探索的重要挑战。
这是对一项随机临床试验数据的二次分析，该试验有一个对照组和两个干预组。分析的重点是在30个月的数据收集期内，患有复杂疾病的儿童进行的计划内和计划外临床及治疗就诊。使用非参数检验比较三组之间以及组内的就诊次数。
所有组的计划外就诊次数均随时间减少，视频远程医疗干预组减少最多。在所有时间段内，视频远程医疗组的计划内就诊次数更高。
由高级执业注册护士提供的远程医疗护理协调可能有助于患有复杂疾病的儿童从计划外医疗保健服务使用转向计划内医疗保健服务使用。
