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虚拟门诊作为手术出院后实际门诊就诊的替代方式:一项随机对照试验。

Virtual outpatient clinic as an alternative to an actual clinic visit after surgical discharge: a randomised controlled trial.

机构信息

Department of Surgery, Connolly Hospital, Royal College of Surgeons in Ireland, Dublin, Ireland

Department of General Surgery, Connolly Hospital, Dublin, Ireland.

出版信息

BMJ Qual Saf. 2019 Jan;28(1):24-31. doi: 10.1136/bmjqs-2018-008171. Epub 2018 Oct 5.

Abstract

BACKGROUND

It is standard practice to review all patients following discharge at a follow-up clinic but demands on all health services outweigh resources and unnecessary review appointments may delay or deny access to patients with greater needs.

AIMS

This randomised trial aimed to establish whether a virtual outpatient clinic (VOPC) was an acceptable alternative to an actual outpatient clinic (OPC) attendance for a broad range of general surgical patients following a hospital admission.

PATIENTS AND METHODS

All patients admitted under one general surgical service over the study period were assessed. If eligible for inclusion the rationale, randomisation and follow-up methods were explained, consent was sought and patients randomised to receive either a VOPC or an OPC appointment.

RESULTS

Two-hundred and nine patients consented to study inclusion, of which 98/107 (91.6%) in the VOPC group and 83/102 (81.4%) in the OPC group were successfully contacted. Only 6 patients in the OPC group and 10 in the VOPC group reported ongoing issues. A further follow-up indicated 78 of 82 (95%) VOPC patients were very happy with their overall experience compared with 34/61 (56%) in the actual OPC group (p<0.001). A significant proportion of both cohorts-68/82 (83%) in VOPC group and 41/61 (67%) in OPC group (p = 0.029)-preferred a VOPC appointment as their future follow-up of choice.

CONCLUSIONS

The majority of patients discharged from a surgical service could be better followed up by a virtual clinic with a significant proportion of patients reporting a preference for and a greater satisfaction with such a service.

摘要

背景

在随访诊所对所有出院患者进行复查是标准做法,但所有卫生服务的需求都超过了资源,不必要的复查预约可能会延迟或拒绝为有更大需求的患者提供服务。

目的

本随机试验旨在确定虚拟门诊(VOPC)是否可以作为一种替代实际门诊(OPC)的方式,用于广泛的普通外科患者在住院后进行随访。

患者和方法

研究期间评估了所有在一个普通外科服务下入院的患者。如果符合纳入标准,将解释纳入的理由、随机化和随访方法,征求同意,并对患者进行随机分组,接受 VOPC 或 OPC 预约。

结果

共有 209 名患者同意参与研究,其中 VOPC 组 98/107(91.6%)和 OPC 组 83/102(81.4%)的患者成功联系上。OPC 组仅有 6 名患者和 VOPC 组 10 名患者报告持续存在问题。进一步随访显示,82 名 VOPC 患者中有 78 名(95%)对他们的整体体验非常满意,而 61 名 OPC 患者中有 34 名(56%)(p<0.001)。两个队列中有相当大比例的患者-VOPC 组 68/82(83%)和 OPC 组 41/61(67%)(p=0.029)-更喜欢 VOPC 预约作为他们未来的随访选择。

结论

大多数从外科服务中出院的患者可以通过虚拟诊所得到更好的随访,相当一部分患者报告对这种服务的偏好和更高的满意度。

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