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使用临床视频远程医疗进行术前评估与住院时间的关联:描述性分析

The Association of Medical Preoperative Evaluation Using Clinical Video Telehealth With Hospital Length of Stay: Descriptive Analysis.

作者信息

Burton Brittany Nicole, Arastoo Sara, Wu Simon, Liu Nancy, Ong Michael K, Vazirani Sondra

机构信息

Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles Health, Los Angeles, CA, United States.

Department of Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States.

出版信息

JMIR Form Res. 2022 Jul 25;6(7):e38054. doi: 10.2196/38054.

Abstract

BACKGROUND

Preoperative medical evaluation serves to identify risk factors and optimize patients before surgery. Providing a telehealth option in the perioperative setting has played a significant role in reducing barriers to quality perioperative health care.

OBJECTIVE

We aimed to evaluate how telemedicine preoperative evaluations using Clinical Video Telehealth (CVT) impact hospital length of stay.

METHODS

We performed a retrospective chart review between 2016 and 2017 of adult patients who underwent evaluations in our hospitalist-run preoperative medicine clinic. Patients seen in our preoperative CVT program were compared to patients seen in person to evaluate the association of visit type (preoperative CVT versus in-person evaluation) with hospital length of stay, defined as hospital stay from postoperative day 0 to discharge. There were 62 patients included in this retrospective study.

RESULTS

The adjusted incidence rate ratio (IRR) for hospital length of stay was significantly shorter in patients who underwent preoperative CVT compared to an in-person visit (IRR 0.52, 95% CI 0.29-0.92, P=.02).

CONCLUSIONS

After adjusting for age and comorbidities, we show that preoperative telemedicine in the perioperative setting is associated with a shorter hospital length of stay compared to in-person visits. This suggests that telemedicine can play a viable role in this clinical setting.

摘要

背景

术前医学评估旨在识别风险因素并在手术前优化患者状况。在围手术期提供远程医疗选项在减少优质围手术期医疗保健障碍方面发挥了重要作用。

目的

我们旨在评估使用临床视频远程医疗(CVT)进行的远程医疗术前评估如何影响住院时间。

方法

我们对2016年至2017年在我院内科医生管理的术前医学诊所接受评估的成年患者进行了回顾性病历审查。将我们术前CVT项目中的患者与亲自就诊的患者进行比较,以评估就诊类型(术前CVT与亲自评估)与住院时间的关联,住院时间定义为从术后第0天到出院的住院时间。这项回顾性研究纳入了62例患者。

结果

与亲自就诊相比,接受术前CVT的患者住院时间的调整发病率比(IRR)显著缩短(IRR 0.52,95%CI 0.29 - 0.92,P = 0.02)。

结论

在调整年龄和合并症后,我们表明围手术期的术前远程医疗与亲自就诊相比,住院时间更短。这表明远程医疗在这种临床环境中可以发挥可行的作用。

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本文引用的文献

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Telemedicine pre-anesthesia evaluation: a randomized pilot trial.远程医疗麻醉前评估:一项随机试点试验。
Telemed J E Health. 2013 Mar;19(3):211-6. doi: 10.1089/tmj.2012.0132. Epub 2013 Feb 5.

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