IMT Atlantique (Télécom Bretagne),
réseau TELAP.
Int J Technol Assess Health Care. 2018 Jan;34(6):567-575. doi: 10.1017/S0266462318000685. Epub 2018 Oct 29.
Chronic wounds are frequent, affect quality of life, and increase care costs. Telemedicine provides potential for effective wound care management, especially for the monitoring of complex wounds at home.
The objective of the present study was to determine the clinical effects and costs of telemedicine for the follow-up of complex chronic wounds from the perspective of the public health insurance. The study ran over a period of 9 months.
We conducted a prospective, pragmatic, open-label, observational study and carried out a cost-effectiveness analysis. A total of 116 patients with chronic wounds were assigned to their choice of two groups: telemedicine (N = 77) and traditional follow-up (control; N = 39). The primary outcome was the time to healing. Secondary outcomes included percentage of wounds reaching target objective, percentage of wounds healed completely, outpatient care costs, travel costs, and hospitalizations.
Time to healing was shorter in the telemedicine group than in the control group (137 versus 174 days; p .05). Outpatient care and hospitalization costs were not significantly different. The main results in terms of economic savings were medical transport costs reimbursed by the French public health insurance, which were significantly lower in the telemedicine group. Telemedicine costs were found to be €4,583 less per patient compared with standard practice over 9 months.
This trial suggests that telemedicine saves travel costs and results in a shorter healing time than traditional follow-up.
慢性伤口很常见，会影响生活质量并增加护理成本。远程医疗为有效的伤口护理管理提供了潜力，特别是对于在家中监测复杂伤口而言。
本研究旨在从公共医疗保险的角度确定远程医疗在随访复杂慢性伤口方面的临床效果和成本。该研究持续了 9 个月。
我们进行了一项前瞻性、实用、开放标签、观察性研究，并进行了成本效益分析。共有 116 名患有慢性伤口的患者被分配到他们选择的两组之一：远程医疗（n = 77）和传统随访（对照组；n = 39）。主要结局是愈合时间。次要结局包括达到目标目标的伤口百分比、完全愈合的伤口百分比、门诊护理费用、旅行费用和住院费用。
远程医疗组的愈合时间短于对照组（137 天比 174 天；p <.05）。门诊护理和住院费用无显著差异。远程医疗组在医疗运输成本方面的主要节省结果是法国公共医疗保险报销的费用，这明显低于传统随访组。与 9 个月的标准治疗相比，远程医疗组每位患者可节省 4583 欧元的费用。
本试验表明，与传统随访相比，远程医疗可节省旅行费用并缩短愈合时间。
