评估德国骨科和创伤外科患者视频咨询随访中的远程医疗效率：随机对照试验。
Assessing Telemedicine Efficiency in Follow-up Care With Video Consultations for Patients in Orthopedic and Trauma Surgery in Germany: Randomized Controlled Trial.
机构信息
Department of Health Economics, Justus Liebig University Giessen, Giessen, Germany.
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen, Giessen, Germany.
出版信息
J Med Internet Res. 2022 Jul 27;24(7):e36996. doi: 10.2196/36996.
BACKGROUND
Telemedicine can help mitigate important health care challenges, such as demographic changes and the current COVID-19 pandemic, in high-income countries such as Germany. It gives physicians and patients the opportunity to interact via video consultations, regardless of their location, thus offering cost and time savings for both sides.
OBJECTIVE
We aimed to investigate whether telemedicine can be implemented efficiently in the follow-up care for patients in orthopedic and trauma surgery, with respect to patient satisfaction, physician satisfaction, and quality of care.
METHODS
We conducted a prospective randomized controlled trial in a German university hospital and enrolled 60 patients with different knee and shoulder conditions. For follow-up appointments, patients received either an in-person consultation in the clinic (control group) or a video consultation with their physician (telemedicine group). Patients' and physicians' subsequent evaluations of these follow-up appointments were collected and assessed using separate questionnaires.
RESULTS
On the basis of data from 52 consultations after 8 withdrawals, it was found that patients were slightly more satisfied with video consultations (mean 1.58, SD 0.643) than with in-clinic consultations (mean 1.64, SD 0.569), although the difference was not statistically significant (P=.69). After excluding video consultations marred by technical problems, no significant difference was found in physician satisfaction between the groups (mean 1.47, SD 0.516 vs mean 1.32, SD 0.557; P=.31). Further analysis indicated that telemedicine can be applied to broader groups of patients and that patients who have prior experience with telemedicine are more willing to use telemedicine for follow-up care.
CONCLUSIONS
Telemedicine can be an alternative and efficient form of follow-up care for patients in orthopedic and trauma surgery in Germany, and it has no significant disadvantages compared with in-person consultations in the clinic.
TRIAL REGISTRATION
German Clinical Trials Register DRKS00023445; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00023445.
背景
远程医疗可以帮助缓解高收入国家（如德国）的重要医疗保健挑战，如人口结构变化和当前的 COVID-19 大流行。它使医生和患者能够通过视频咨询进行互动，无论他们的位置如何，从而为双方节省成本和时间。
目的
我们旨在研究远程医疗是否可以在骨科和创伤外科的患者随访中高效实施，同时考虑患者满意度、医生满意度和护理质量。
方法
我们在一家德国大学医院进行了一项前瞻性随机对照试验，招募了 60 名患有不同膝关节和肩部疾病的患者。对于随访预约，患者要么在诊所接受面对面咨询（对照组），要么与医生进行视频咨询（远程医疗组）。通过单独的问卷收集和评估患者和医生对这些随访预约的后续评估。
结果
基于 8 次退出后 52 次咨询的数据，发现患者对视频咨询的满意度略高于在诊所进行的咨询（平均 1.58，SD 0.643 对平均 1.64，SD 0.569），尽管差异无统计学意义（P=.69）。排除视频咨询中存在技术问题后，两组医生满意度无显著差异（平均 1.47，SD 0.516 对平均 1.32，SD 0.557；P=.31）。进一步分析表明，远程医疗可以应用于更广泛的患者群体，并且有远程医疗经验的患者更愿意将远程医疗用于随访护理。
结论
远程医疗可以成为德国骨科和创伤外科患者替代和高效的随访护理方式，与在诊所进行的面对面咨询相比，没有明显的劣势。
试验注册
德国临床试验注册处 DRKS00023445；https://www.drks.de/drks_web/navigate.do？navigationId=trial.HTML&TRIAL_ID=DRKS00023445。
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