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比较新冠疫情期间远程医疗与传统门诊对患者管理的效果:一项呼吸评估门诊的横断面研究。

Comparing telehealth to traditional office visits for patient management in the COVID-19 pandemic: A cross-sectional study in a respiratory assessment clinic.

机构信息

Wake Forest School of Medicine, Wake Forest Baptist Health, USA.

出版信息

J Telemed Telecare. 2023 Jun;29(5):374-381. doi: 10.1177/1357633X21990197. Epub 2021 Feb 1.

Abstract

INTRODUCTION

The aim of this study was to examine whether telehealth is as safe and effective as traditional office visits in assessing and treating patients with symptoms consistent with COVID-19.

METHODS

In this retrospective cross-sectional study, the primary outcome was any 14-day related healthcare follow-up event(s). Secondary outcomes were the type of 14-day related follow-up event including hospital admission, emergency department visit, office visit, telehealth visit and/or multiple follow-up visits. Individual visit types were identified due to the significant difference between a hospital admission and an office visit. Logistic regressions were done using the predictors of visit type, age, gender and comorbidities and the primary outcome variable of a related follow-up visit and then by follow-up type: hospital admission, emergency department visit or office visit.

RESULTS

Of 1305 visits, median age was 42.3 years and 65.8% were female. Traditional office visits accounted for 741 (56.8%) of initial visits, while 564 (43.2%) visits occurred via telehealth. One hundred and forty-six (25.9%) of the telehealth visits resulted in a 14-day related healthcare follow-up visit versus 161 (21.7%) of the office visits (adjusted odds ratio (OR) 1.22, 95% CI 0.94-1.58).

DISCUSSION

There was no significant difference in related follow-ups of initial telehealth visits compared to initial office visits including no significant difference in hospital admission or emergency department visits. These findings suggest that based on follow up healthcare utilization, telehealth may be a safe and effective option in assessing and treating patients with respiratory symptoms as the COVID-19 pandemic continues.

摘要

介绍

本研究旨在评估远程医疗在评估和治疗 COVID-19 症状患者方面是否与传统门诊同样安全有效。

方法

在这项回顾性横断面研究中,主要结果是任何 14 天相关医疗保健随访事件。次要结果是 14 天相关随访事件的类型,包括住院、急诊就诊、门诊就诊、远程医疗就诊和/或多次随访就诊。由于住院和门诊就诊之间存在显著差异,因此确定了各次就诊类型。使用就诊类型、年龄、性别和合并症的预测因子以及相关随访就诊的主要结局变量进行逻辑回归,然后根据随访类型(住院、急诊就诊或门诊就诊)进行回归。

结果

在 1305 次就诊中,中位数年龄为 42.3 岁,女性占 65.8%。传统门诊就诊占初始就诊的 741 次(56.8%),而远程医疗就诊占 564 次(43.2%)。146 次远程医疗就诊导致 14 天相关医疗保健随访就诊,而 161 次门诊就诊导致 14 天相关医疗保健随访就诊(调整后的优势比(OR)为 1.22,95%CI 为 0.94-1.58)。

讨论

与初始门诊就诊相比,初始远程医疗就诊的相关随访并无显著差异,包括住院或急诊就诊无显著差异。这些发现表明,基于后续医疗保健的利用情况,在继续应对 COVID-19 大流行期间,远程医疗可能是评估和治疗呼吸症状患者的安全有效选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0559/10197157/d397104263e5/10.1177_1357633X21990197-fig1.jpg

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