The University of Kansas Cancer Center, Westwood, Kansas, USA.
Hospice Services and Palliative Care of Northwest Kansas, Inc., Phillipsburg, Kansas, USA.
J Palliat Med. 2021 Sep;24(10):1461-1466. doi: 10.1089/jpm.2020.0117. Epub 2021 Apr 1.
Hospice care in rural areas is often characterized by provider shortages and vast geographical service areas to cover, making access to quality end-of-life care challenging. Telemedicine, broadly, is the utilization of interactive televideo (ITV) technology to provide health services over a distance. For over 25 years, telemedicine has been proposed as a solution to address access issues. In 2015, the University of Kansas Medical Center (Kansas City, Kansas) partnered with Hospice Services, Inc. (HSI) (Phillipsburg, Kansas), to augment traditional, face-to-face (FTF) hospice care with hospice care delivered through mobile tablets. This work examines the costs of TeleHospice (TH) (telemedicine use in hospice care) when compared with the costs of FTF hospice services. Detailed administrative data from July 1, 2018, to December 31, 2018, were analyzed to estimate the costs of service after TH use was inculcated into routine practice. his, which averages a daily census of 34 patients, conducted 257 calls, averaging 28 hours a month. The average time for a TH call was 18 and 17 minutes for nursing and medical director calls, respectively. Through various hospice functions, including administrative, patient, and nonpatient-related connections, HSI saved over $115,000 in staff travel time and mileage reimbursement. Administratively, by hosting their weekly 15-member interdisciplinary meeting through ITV, HSI saved $29,869 of staff travel time and mileage reimbursement. Our estimates indicate substantial cost saving potential with the use of TH services. Further research is needed to assess the effects of TH utilization on the experiences and subsequent cost of hospice care.
农村地区的临终关怀服务往往存在服务提供者短缺和覆盖广阔地理区域的问题，因此获得高质量的临终关怀服务具有挑战性。远程医疗通常是指利用交互式电视（ITV）技术在远程提供医疗服务。25 年来，远程医疗一直被提议作为解决获取问题的一种方法。2015 年，堪萨斯大学医学中心（堪萨斯州堪萨斯城）与 Hospice Services, Inc.（HSI）（堪萨斯州菲利普斯堡）合作，通过移动平板电脑提供远程医疗服务，以补充传统的面对面临终关怀服务。本研究考察了与面对面临终关怀服务相比，远程医疗在临终关怀服务中的使用（TeleHospice，TH）的成本。对 2018 年 7 月 1 日至 2018 年 12 月 31 日的详细行政数据进行了分析，以估算在常规实践中纳入远程医疗服务后的服务成本。HSI 每月平均有 28 小时，每天有 34 名患者，共进行了 257 次电话咨询。TH 电话的平均时间分别为护理主任和医疗主任电话的 18 分钟和 17 分钟。通过各种临终关怀功能，包括行政、患者和非患者相关的联系，HSI 在员工差旅时间和里程报销方面节省了超过 115,000 美元。HSI 通过 ITV 主持每周一次的 15 人跨学科会议，节省了 29,869 美元的员工差旅时间和里程报销。我们的估计表明，使用 TH 服务具有很大的节省成本潜力。需要进一步研究来评估 TH 利用对临终关怀服务体验和后续成本的影响。
