The Center for Surgical Outcomes Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio.
J Surg Res. 2022 Sep;277:138-147. doi: 10.1016/j.jss.2022.02.023. Epub 2022 Apr 27.
Telemedicine use within pediatric surgery fields has been growing, but research on the utility of remote evaluation in the perioperative period remains scarce. The objective of this study was to examine the utility of perioperative telemedicine care for the pediatric patient by evaluating the outcomes following completion of an outpatient appointment with a surgical provider.
We performed a retrospective chart review of all patients who completed a telemedicine appointment with a provider across nine pediatric surgery divisions, without a limitation based on patient-specific characteristics or telemedicine platform. We examined the result of the initial telemedicine appointment and the outcome of any surgical procedure that was performed as a result.
A total of 803 patients were evaluated by telemedicine during the study period. Of the 164 encounters (20.2%) that were followed by a surgery, nearly 70% were performed using a video. There was no discordance in the preoperative and postoperative diagnoses for more than 98% of patients. Nearly 25% of operations were followed by at least a 1-night hospital stay and 6.7% of patients developed a postoperative complication.
Telemedicine is a safe tool for evaluating pediatric patients in the preoperative and postoperative phases of care and offers potential value for families seeking an alternative to the traditional in-person appointment. Ongoing support will require permanent legislative changes aimed at ensuring comparable compensation and the development of strategies to adapt the outpatient healthcare model to better accommodate the evolving requirements of remotely evaluating and treating pediatric patients.
远程医疗在小儿外科学领域的应用一直在增长,但有关围手术期远程评估实用性的研究仍然很少。本研究的目的是通过评估外科医生门诊就诊后患者的结局,来检验小儿患者围手术期远程医疗护理的实用性。
我们对九个小儿外科学科的所有通过远程医疗与提供者完成门诊就诊的患者进行了回顾性图表审查,没有根据患者的具体特征或远程医疗平台进行限制。我们检查了初始远程医疗预约的结果以及因此而进行的任何手术的结果。
在研究期间,共有 803 名患者接受了远程医疗评估。在 164 次就诊中(20.2%),有近 70%是通过视频进行的。超过 98%的患者术前和术后诊断没有差异。近 25%的手术需要至少 1 晚的住院治疗,6.7%的患者出现术后并发症。
远程医疗是评估小儿患者围手术期护理的安全工具,为寻求替代传统门诊就诊的家庭提供了潜在价值。持续的支持将需要永久性的立法改革,旨在确保可比的补偿,并制定战略,使门诊医疗模式适应远程评估和治疗小儿患者不断发展的需求。