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一个基于网络的交互式医患软件平台并不能提高在单一大型医院系统中接受全膝关节和髋关节置换术患者的满意度或降低医院资源利用率。

A Web-Based Interactive Patient-Provider Software Platform Does Not Increase Patient Satisfaction or Decrease Hospital Resource Utilization in Total Knee and Hip Arthroplasty Patients in a Single Large Hospital System.

机构信息

Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH.

Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL.

出版信息

J Arthroplasty. 2021 Jul;36(7):2290-2296.e1. doi: 10.1016/j.arth.2021.01.037. Epub 2021 Jan 21.

Abstract

BACKGROUND

Web-based platforms used to enhance patient-provider communication are being explored to improve patient satisfaction and care delivery, and decrease cost. This study tested a web-based interactive patient-provider software platform (IPSP), JointCOACH, which enabled patient communication with their care team and preparatory/recovery guidance. The aims of this study are to compare (1) patient satisfaction and (2) healthcare resource utilization by patients who underwent total knee and hip replacements and added IPSP to standard of care (SOC).

METHODS

This study is a prospective, randomized clinical trial at a single large academic healthcare system. Between May 2018 and March 2020, 399 patients undergoing elective total hip or knee arthroplasty were randomized to SOC arm (n = 204) or SOC + IPSP arm (n = 195). Patient demographics, surgical details, and comorbidities were collected. Patient satisfaction was assessed using Visual Analog Scale and the Picker Patient Experience-15. Healthcare utilization was measured using length of stay, emergency department and office visits, office calls, readmissions, and reoperations at 30 and 90 days after surgery.

RESULTS

No difference was found in length of stay between SOC and SOC + IPSP. No differences were found in 30-day or 90-day satisfaction or in healthcare resource utilization (P > .05) including number of office and emergency department visits, phone calls, and readmissions.

CONCLUSION

Statistical differences were not found in satisfaction and healthcare utilization with the addition of IPSP to SOC. IPSP can be used to reinforce patient education and communication between the patient and provider, and should be evaluated as an element of virtual care rather than supplementing traditional in-office follow-up. CLINICALTRIALS.GOV: More information on this study can be found at clinicaltrials.gov NCT03499028.

摘要

背景

正在探索基于网络的平台,以增强医患沟通,从而提高患者满意度和改善医疗服务提供,并降低成本。本研究测试了一种基于网络的互动医患软件平台(IPSP),即 JointCOACH,它使患者能够与他们的医护团队进行沟通,并提供预备/康复指导。本研究的目的是比较(1)接受全膝关节和髋关节置换术并在标准护理(SOC)基础上增加 IPSP 的患者的满意度,以及(2)患者的医疗资源利用情况。

方法

这是一项在单一大型学术医疗系统进行的前瞻性、随机临床试验。在 2018 年 5 月至 2020 年 3 月期间,399 名接受择期全髋关节或全膝关节置换术的患者被随机分为 SOC 组(n=204)或 SOC+IPSP 组(n=195)。收集患者人口统计学、手术细节和合并症等信息。使用视觉模拟量表(VAS)和 Picker 患者体验量表-15 评估患者满意度。通过住院时间、急诊和门诊就诊、门诊电话咨询、再入院和术后 30 天和 90 天的再次手术来衡量医疗资源利用情况。

结果

SOC 和 SOC+IPSP 组之间的住院时间无差异。30 天和 90 天的满意度或医疗资源利用(P>.05)方面,包括门诊和急诊就诊次数、电话咨询次数和再入院率,两组之间均无差异。

结论

在 SOC 基础上增加 IPSP 并未在满意度和医疗资源利用方面产生统计学差异。IPSP 可用于加强患者教育和医患沟通,应将其视为虚拟护理的一部分,而不是补充传统的门诊随访。CLINICALTRIALS.GOV: 更多关于该研究的信息可在 clinicaltrials.gov 上找到,NCT03499028。

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