J Healthc Qual. 2021;43(4):204-213. doi: 10.1097/JHQ.0000000000000299.
Preventing postoperative 30-day readmissions requires an investment in patient care. The use of postdischarge telehealth visits to prevent potential adverse events or hospital visits has been shown in previous studies.
We aim to determine the impact of postoperative telehealth visits (PTV) on reducing emergency department visits (EDV) and readmissions within 30 days postdischarge (30DR).
All elective thoracic surgery patients opted-in or opted-out of PTV. Postoperative telehealth visits assessed patients' overall health status and addressed patient concerns. Patients were also seen at their postoperative clinic follow-up. Emergency department visits and 30DR were recorded.
Three hundred fourty-one patients were included-295 and 46 patients opted-in and opted-out of PTV. Opting-out of PTV, being discharged with chest tubes or drains, and the inability to perform activities of daily living at their postoperative follow-up were associated with increased EDV (OR = 8.7, 5.3, 6.3; p ≤ .05) and 30DR (OR = 5.1, 6.3, 7.1; p ≤ .05).
Postoperative telehealth visits were able to reduce EDV and 30DR in our study, although further studies establishing the range of interventions that can be feasibly provided remotely should be performed to identify limitations of these PTV.
Telehealth could be used postoperatively to reduce EDV and 30DR, improving quality and cost-effectiveness of healthcare delivery to patients.
预防术后 30 天再入院需要对患者护理进行投资。先前的研究表明，使用出院后远程医疗访视来预防潜在的不良事件或医院就诊是有效的。
我们旨在确定术后远程医疗访视（PTV）对减少术后 30 天内急诊就诊（EDV）和再入院的影响。
所有择期胸部手术患者选择参加或不参加 PTV。术后远程医疗访视评估患者的整体健康状况并解决患者的担忧。患者还在术后门诊随访时就诊。记录 EDV 和 30DR。
共纳入 341 例患者-295 例和 46 例患者选择参加和不参加 PTV。不参加 PTV、出院时带有胸腔引流管或引流管，以及在术后随访时无法进行日常生活活动与 EDV（OR=8.7、5.3、6.3；p≤0.05）和 30DR（OR=5.1、6.3、7.1；p≤0.05）增加相关。
尽管需要进一步研究确定可以远程提供的干预范围，以确定这些 PTV 的局限性，但本研究中术后远程医疗访视能够减少 EDV 和 30DR。
远程医疗可以在术后用于减少 EDV 和 30DR，从而提高患者医疗服务的质量和成本效益。
