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通过远程医疗访问提供高价值的炎症性肠病护理。

Delivering High Value Inflammatory Bowel Disease Care Through Telemedicine Visits.

机构信息

*Dartmouth Geisel School of Medicine, Hanover, New Hampshire; and †Dartmouth-Hitchcock Inflammatory Bowel Disease Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.

出版信息

Inflamm Bowel Dis. 2017 Oct;23(10):1678-1681. doi: 10.1097/MIB.0000000000001210.

Abstract

BACKGROUND

Patients with inflammatory bowel disease (IBD) require regular follow-up to manage their care, which requires significant amount of time and out-of-pocket costs. Telemedicine in the form of video virtual visits could serve as an alternative to in-office visits. The aim of this project was to understand if telemedicine can provide high value care (defined as quality/cost) to outpatients with IBD.

METHODS

Patients who participated in the IBD telemedicine clinic in the second half of 2015 were included. Patient-reported survey data before and after the virtual visit were collected. A retrospective review was performed on the study cohort for quality outcome measures a year before and after starting the telemedicine clinic. Outcomes were analyzed using simple descriptive statistics. Differences in quality outcomes were compared using odds ratios.

RESULTS

Forty-eight patients were included in the analysis. Most patients travel more than 25 miles each way, take half a day off, and on average incur an additional out-of-pocket cost of $62 for an in-office visit. Most patients (98%) agreed that there was enough time spent with their physician, 91% agreed that they felt like the physician understood their disease state, and 78% reported that they clearly understood the follow-up plan after the visit. Analysis of quality outcome measures did not show any drop in the overall quality of care, after initiating the telemedicine program.

CONCLUSIONS

Telemedicine offers a low cost and convenient alternative for patients with IBD without compromising quality of care.

摘要

背景

炎症性肠病(IBD)患者需要定期随访以管理其病情,这需要大量的时间和自付费用。视频虚拟就诊形式的远程医疗可以作为门诊就诊的替代方式。本项目旨在了解远程医疗是否可以为 IBD 门诊患者提供高价值的护理(定义为质量/成本)。

方法

纳入 2015 年下半年参加 IBD 远程医疗诊所的患者。收集虚拟就诊前后患者报告的调查数据。对研究队列进行回顾性研究,以评估远程医疗诊所开设前后一年的质量结果指标。使用简单描述性统计分析结果。使用优势比比较质量结果的差异。

结果

共纳入 48 例患者进行分析。大多数患者往返路程超过 25 英里,需要请半天假,并且每次门诊就诊的自付费用平均增加 62 美元。大多数患者(98%)认为与医生的交流时间足够,91%的患者认为医生了解他们的病情,78%的患者表示在就诊后清楚了解了随访计划。在启动远程医疗项目后,对质量结果指标的分析并未显示整体护理质量下降。

结论

远程医疗为 IBD 患者提供了一种低成本、便捷的替代方式,同时不会降低护理质量。

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