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使用虚拟就诊为有 COVID-19 症状的初级保健患者提供护理。

Using Virtual Visits to Care for Primary Care Patients With COVID-19 Symptoms.

机构信息

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT, EMH, MAB); Division of Sports Medicine, Department of Family Medicine, University of California, Los Angeles, Los Angeles, CA (CH, SPS).

出版信息

J Am Board Fam Med. 2021 Feb;34(Suppl):S147-S151. doi: 10.3122/jabfm.2021.S1.200241.

Abstract

PURPOSE

Examine use of office resources by primary care patients who were initially evaluated through telehealth, telephone, or in-person encounters.

METHODS

Retrospective electronic health record review on patients seen in March 2020 for evaluation of potential COVID-19 symptoms, to assess the total number of interactions with physicians and office staff.

RESULTS

Of 202 patients, 89 (44%) had initial telehealth, 55 (27%) telephone, and 52 (26%) in-person encounters. Patients initially evaluated through telehealth, telephone, and in-person encounters had a mean of 6.1 (S.D. = 3.7), 5.2 (S.D. = 3.6), and 4.5 (S.D. = 3.0) total interactions with the office, respectively (P = .03), and 9%, 12.7%, and 19.2%, respectively, had a subsequent in-person or emergency department visit (P = .22). Multivariable analysis showed no differences in number of office interactions based on initial visit type; older patients (95% CI = 0.00-0.07) and those with subjective fevers (95% CI = 1.01-3.01) or shortness of breath (95% CI = 0.23-2.28) had more interactions with the office.

CONCLUSION

Primary care providers used virtual visits to care for most patients presenting with potential COVID-19 symptoms, with many patients choosing telephone over telehealth visits. Virtual visits can successfully limit patient exposure to other people, and consideration could be given to increasing its use for patients with potential symptoms of COVID-19.

摘要

目的

考察通过远程医疗、电话或面对面方式初次就诊的初级保健患者对医疗资源的使用情况。

方法

对 2020 年 3 月因疑似 COVID-19 症状就诊的患者进行回顾性电子病历审查,以评估与医生和办公室工作人员的总交互次数。

结果

在 202 名患者中,89 名(44%)患者最初接受远程医疗,55 名(27%)患者接受电话就诊,52 名(26%)患者面对面就诊。通过远程医疗、电话和面对面方式初次就诊的患者与办公室的总交互次数分别为 6.1(标准差 = 3.7)、5.2(标准差 = 3.6)和 4.5(标准差 = 3.0)(P = .03),分别有 9%、12.7%和 19.2%的患者随后进行了面对面或急诊就诊(P = .22)。多变量分析显示,初始就诊类型与办公室交互次数无差异;年龄较大的患者(95%置信区间 = 0.00-0.07)和有主观发热(95%置信区间 = 1.01-3.01)或呼吸急促(95%置信区间 = 0.23-2.28)的患者与办公室的交互次数更多。

结论

初级保健提供者使用虚拟就诊来治疗大多数出现疑似 COVID-19 症状的患者,许多患者选择电话就诊而非远程医疗就诊。虚拟就诊可以成功限制患者与他人接触,对于有疑似 COVID-19 症状的患者,可以考虑增加其使用。

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