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新冠疫情期间远程分诊的效果:系统评价和叙述性综合。

The effectiveness of tele-triage during the COVID-19 pandemic: A systematic review and narrative synthesis.

机构信息

Health Information Management Research Center, Department of Health Information Management & Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran.

出版信息

J Telemed Telecare. 2024 Oct;30(9):1367-1375. doi: 10.1177/1357633X221150278. Epub 2023 Jan 23.

Abstract

BACKGROUND

Telehealth services were used by healthcare centers during the COVID-19 pandemic in order to identify and manage patients at the forefront of the healthcare system. As one of these technologies, tele-triage refers to the assessment of a patient's health status through telephone or another means of communication and recommending treatment or providing appropriate referrals in emergency rooms and primary care offices. This study aimed to perform a systematic review of the evidence on the effectiveness of tele-triage, as one of these technologies, during the COVID-19 pandemic.

METHODS

Medline (via PubMed), Scopus, and Web of Science databases were searched for relevant English articles published since the pandemic's onset until December 30, 2021. Studies investigating the tele-triage's effect on patient safety, clinical outcomes, and patient satisfaction were included. Data on study characteristics, intervention characteristics, and their effects on study outcomes were extracted separately by two authors. A narrative synthesis of the included studies was ultimately performed.

RESULTS

Out of the 6312 retrieved studies, 14 met the inclusion criteria. The tele-triage intervention was offered by an algorithm-based system in eight studies (57.14%) and by healthcare providers in six other studies (42.86%) to determine the patient's level of care. According to the results, tele-triage interventions during COVID-19 can reduce unnecessary emergency room visits (by 1.2-22.2%), improve clinical outcomes after intervention (such as would closure in diabetic feet), reduce mortality and injuries, and ensure patient satisfaction with tele-triage (53-98%).

CONCLUSIONS

This study found that tele-triage interventions reduced unnecessary visits, improved clinical outcomes, reduced mortality, and injuries, increased patient satisfaction, reduced healthcare provider workload, improved access to primary care consultation, and increased patient safety and satisfaction. Therefore, tele-triage systems are not only suitable for providing acute and emergency care remotely but they are also recommended as an alternative tool to monitor and diagnose COVID-19.

摘要

背景

在 COVID-19 大流行期间,医疗中心使用远程医疗服务来识别和管理医疗系统中的前沿患者。作为这些技术之一,远程分诊是指通过电话或其他通信方式评估患者的健康状况,并在急诊室和初级保健办公室推荐治疗或提供适当的转诊。本研究旨在对 COVID-19 大流行期间远程分诊作为其中一种技术的有效性进行系统评价。

方法

检索了 Medline(通过 PubMed)、Scopus 和 Web of Science 数据库中自大流行开始至 2021 年 12 月 30 日发表的相关英文文章。纳入了研究远程分诊对患者安全、临床结局和患者满意度影响的文章。两位作者分别提取了研究特征、干预特征及其对研究结果的影响的数据。最终对纳入的研究进行了叙述性综合。

结果

在 6312 篇检索到的研究中,有 14 项符合纳入标准。远程分诊干预由基于算法的系统在 8 项研究(57.14%)中提供,由医疗保健提供者在另外 6 项研究(42.86%)中提供,以确定患者的护理水平。结果表明,COVID-19 期间的远程分诊干预可减少不必要的急诊就诊(1.2-22.2%),改善干预后的临床结局(如糖尿病足的闭合),降低死亡率和伤害,并确保患者对远程分诊的满意度(53-98%)。

结论

本研究发现,远程分诊干预可减少不必要的就诊,改善临床结局,降低死亡率和伤害,提高患者满意度,减轻医疗保健提供者的工作量,改善初级保健咨询的可及性,并提高患者的安全性和满意度。因此,远程分诊系统不仅适合远程提供急性和紧急护理,而且还被推荐作为监测和诊断 COVID-19 的替代工具。

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