Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00290 Helsinki, Finland.
Department of Public Health, Faculty of Medicine, University of Helsinki, Yliopistonkatu 4, 00100 Helsinki, Finland.
Am J Otolaryngol. 2024 Jul-Aug;45(4):104304. doi: 10.1016/j.amjoto.2024.104304. Epub 2024 Apr 16.
At our clinic, a significant portion of tonsillectomy (TE) preoperative assessments are conducted remotely. The aim of our study was to examine the variation in TE complications, contact rates, and reasons for patient contact between those evaluated preoperatively at the outpatient clinic (OPC), or remotely through virtual visits (VV), or via a digital care pathway (DCP). This investigation is critical for optimizing patient flow through the volume-intensive process of TE.
We conducted a prospective cohort study involving 422 patients who underwent TE at Helsinki University Hospital ENT clinic to investigate their 30-day postoperative course. We extracted information on postoperative contacts, complications, and demographic data. Postoperative contact rate was the primary outcome measure to evaluate whether telehealth patients suffered fewer postoperative issues.
Patients from the OPC were least likely to seek medical assistance in the 30-day postoperative period. However, no significant difference was discovered compared to the remotely assessed DCP patients, and over entire TE episodes, the DCP patients had the fewest unplanned contacts compared to the VV and OPC cohorts. Furthermore, the care paths shared similar complication and contact method profiles with comparable post-tonsillectomy hemorrhage incidence.
A preoperative DCP for TE appeared to carry similar postoperative contact and complication rates, as well as comparable contact method profiles compared to the OPC model. Given the high patient satisfaction and cost-consciousness associated with the DCP, our findings encourage a broader implementation of highly developed DCPs in preoperative assessment for TE.
在我们的诊所，相当一部分的扁桃体切除术（TE）术前评估是远程进行的。我们的研究目的是检查 TE 并发症、联系率以及通过门诊（OPC）术前评估、虚拟就诊（VV）或数字护理途径（DCP）远程评估的患者联系原因的变化。这对于优化 TE 这个大容量流程中的患者流程至关重要。
我们进行了一项前瞻性队列研究，涉及在赫尔辛基大学医院耳鼻喉科诊所接受 TE 的 422 名患者，以调查他们的 30 天术后过程。我们提取了术后联系、并发症和人口统计学数据的信息。术后联系率是评估远程医疗患者是否较少出现术后问题的主要指标。
OPC 患者在 30 天的术后期间最不可能寻求医疗帮助。然而，与远程评估的 DCP 患者相比，没有发现显著差异，并且在整个 TE 发作期间，与 VV 和 OPC 队列相比，DCP 患者的非计划联系最少。此外，这些护理路径具有相似的并发症和联系方法特征，扁桃体切除术后出血的发生率相当。
TE 的术前 DCP 似乎与 OPC 模型相比具有相似的术后联系和并发症发生率，以及可比的联系方法特征。鉴于 DCP 与患者满意度和成本意识相关，我们的发现鼓励在 TE 的术前评估中更广泛地实施高度发达的 DCP。
