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瑞典难愈合溃疡患者视频会诊与面对面评估的比较:基于登记的愈合时间和等待时间研究

Comparing video consultation with inperson assessment for Swedish patients with hard-to-heal ulcers: registry-based studies of healing time and of waiting time.

作者信息

Wickström Hanna L, Öien Rut Frank, Fagerström Cecilia, Anderberg Peter, Jakobsson Ulf, Midlöv Patrik J

机构信息

Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.

Blekinge Wound Healing Centre, Karlshamn, Sweden.

出版信息

BMJ Open. 2018 Feb 15;8(2):e017623. doi: 10.1136/bmjopen-2017-017623.

Abstract

OBJECTIVES

To investigate differences in ulcer healing time and waiting time between video consultation and inperson assessment for patients with hard-to-heal ulcers.

SETTING

Patients treated at Blekinge Wound Healing Centre, a primary care centre covering the whole of Blekinge county (150 000 inhabitants), were compared with patients registered and treated according to the Registry of Ulcer Treatment, a Swedish national web-based quality registry.

PARTICIPANTS

In the study for analysing ulcer healing time, the study group consisted of 100 patients diagnosed through video consultation between October 2014 and September 2016. The control group for analysing healing time consisted of 1888 patients diagnosed through inperson assessment during the same period. In the study for analysing waiting time, the same study group (n=100) was compared with 100 patients diagnosed through inperson assessment.

PRIMARY AND SECONDARY OUTCOME MEASURES

Differences in ulcer healing time were analysed using the log-rank test. Differences in waiting time were analysed using the Mann-Whitney U test.

RESULTS

Median healing time was 59 days (95% CI 40 to 78) in the study group and 82 days (95% CI 75 to 89) in the control group (P<0.001). Median waiting time was 25 days (range: 1-83 days) in the study group and 32 days (range: 3-294 days) for patients diagnosed through inperson assessment (P=0.017). There were no significant differences between the study group and the control group regarding age, gender or ulcer size.

CONCLUSIONS

Healing time and waiting time were significantly shorter for patients diagnosed through video consultation compared with those diagnosed through inperson assessment.

摘要

目的

调查难愈合溃疡患者通过视频会诊和面对面评估的溃疡愈合时间及等待时间的差异。

背景

将在布莱金厄伤口愈合中心接受治疗的患者与在瑞典全国基于网络的质量登记处“溃疡治疗登记处”登记并接受治疗的患者进行比较。布莱金厄伤口愈合中心是一家覆盖整个布莱金厄县(15万居民)的初级保健中心。

参与者

在分析溃疡愈合时间的研究中,研究组由2014年10月至2016年9月期间通过视频会诊确诊的100例患者组成。分析愈合时间的对照组由同期通过面对面评估确诊的1888例患者组成。在分析等待时间的研究中,将同一研究组(n = 100)与100例通过面对面评估确诊的患者进行比较。

主要和次要观察指标

使用对数秩检验分析溃疡愈合时间的差异。使用曼-惠特尼U检验分析等待时间的差异。

结果

研究组的中位愈合时间为59天(95%CI 40至78),对照组为82天(95%CI 75至89)(P<0.001)。研究组的中位等待时间为25天(范围:1 - 83天),通过面对面评估确诊的患者为32天(范围:3 - 294天)(P = 0.017)。研究组和对照组在年龄、性别或溃疡大小方面无显著差异。

结论

与通过面对面评估确诊的患者相比,通过视频会诊确诊的患者愈合时间和等待时间明显更短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1fc/5829745/de617400ac69/bmjopen-2017-017623f01.jpg

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