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高危儿发育筛查的远程视频问诊。

Virtual Visits for Developmental Screening in High-Risk Infants.

机构信息

Kaiser Permanente, Downey, CA, USA.

出版信息

Perm J. 2023 Dec 15;27(4):55-63. doi: 10.7812/TPP/23.014. Epub 2023 Sep 27.

Abstract

INTRODUCTION

The High-Risk Infant Follow-Up program screens neonatal intensive care unit graduates for developmental delays and refers patients to physical, occupational, or speech therapy. At Kaiser Permanente Downey, the High-Risk Infant Follow-Up program assessed development via video visits during the COVID-19 pandemic. This study compares rates of enrollment in and referral to therapies and California Regional Center services between infants assessed by video visits and those assessed in person.

METHODS

Study participants included infants in the High-Risk Infant Follow-Up program between March 2020 and March 2021 with developmental assessments at adjusted ages 6, 12, and 18 months. Rates of enrollment in services and referral to physical, occupational, and speech therapy and Regional Center services were compared between infants assessed virtually and in person.

RESULTS

There were no significant differences in rates of enrollment or referral to physical, occupational, or speech therapy services or Regional Center services. The rate of referral at any of the 3 visits was 8.6% at in-person visits and 10.9% at virtual visits (p = 0.49). Infants whose first visit was virtual were just as likely to complete all 3 developmental assessments as those whose first visit was in person.

DISCUSSION

The COVID-19 pandemic stay-at-home orders provided a "natural experiment" demonstrating the effectiveness of virtual visits as compared to in-person visits. Although the developmental assessment tool used was not standardized to be used virtually, virtual visits were just as likely to result in referrals to services and did not lead to loss of follow-up.

CONCLUSION

Virtual visits may be useful and convenient for some families, but further study is required.

摘要

简介

高危婴儿随访计划通过视频访问为新生儿重症监护病房的毕业生筛查发育迟缓,并将患者转介至物理治疗、职业治疗或言语治疗。在 Kaiser Permanente Downey,高危婴儿随访计划在 COVID-19 大流行期间通过视频访问评估发育情况。本研究比较了通过视频访问评估的婴儿和亲自评估的婴儿在接受治疗和加州地区中心服务方面的入组率和转介率。

方法

研究参与者包括 2020 年 3 月至 2021 年 3 月期间参加高危婴儿随访计划的婴儿,在调整年龄 6、12 和 18 个月时进行发育评估。比较了通过虚拟和亲自评估的婴儿在服务方面的入组率和转介至物理治疗、职业治疗和言语治疗以及地区中心服务的转介率。

结果

在入组或转介至物理治疗、职业治疗或言语治疗服务或地区中心服务方面,没有显著差异。在任何 3 次访问中,面对面访问的转介率为 8.6%,虚拟访问的转介率为 10.9%(p = 0.49)。首次访问为虚拟访问的婴儿与首次访问为面对面访问的婴儿完成所有 3 次发育评估的可能性相同。

讨论

COVID-19 大流行的居家令提供了一个“自然实验”,证明了与面对面访问相比,虚拟访问的有效性。尽管用于评估的工具没有标准化,但虚拟访问同样可能导致转介至服务,而且不会导致随访中断。

结论

虚拟访问对于一些家庭来说可能是有用和方便的,但需要进一步研究。

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