From the Family Medicine Residency Program, WellSpan Good Samaritan Hospital, Lebanon, PA (AZ, DB, AW); and WellSpan Telemedicine Physician, Lebanon, PA (DB).
J Am Board Fam Med. 2024 Mar-Apr;37(2):166-171. doi: 10.3122/jabfm.2023.230213R1.
Unplanned readmissions can be avoided by standardizing and improving the coordination of care after discharge. Telemedicine has been increasingly utilized; however, the quality of this care has not been well studied. Standardized measures can provide an objective comparison of care quality. The purpose of our study was to compare quality performance transitions of care management in the office vs telemedicine.
The Epic SlicerDicer tool was used to compare the percentage of encounters that were completed via telemedicine (video visits); or via in-person for comparison, Chi-squared tests were used.
A total of 13,891 patients met the inclusion criteria during the study time frame. There were 12,846 patients in the office and 1,048 in the telemedicine cohort. The office readmission rate was 11.9% with 1,533 patients out of 12,846 compared with telemedicine with the rate of readmission at 12.1% with 126 patients out of 1,045 patients. The P-value for the Chi-squared test between the prepandemic and study time frame was 0.15 and 0.95, respectively. Demographic comparability was seen.
Our study found a comparable readmission rate between patients seen via in-office and telemedicine for Transitions of Care Management (TCM) encounters. The findings of this study support the growing body of evidence that telemedicine augments quality performance while reducing cost and improving access without negatively impacting HEDIS performance in health care systems.
Telemedicine poses little threat of negatively impacting HEDIS performance and might be as effective as posthospitalization traditional office care transitions of care management.
通过规范和改善出院后的护理协调,可以避免计划外的再次入院。远程医疗的应用越来越广泛;然而,这种护理的质量尚未得到很好的研究。标准化的措施可以为护理质量的客观比较提供依据。我们研究的目的是比较办公室和远程医疗在过渡护理管理方面的质量绩效。
使用 Epic SlicerDicer 工具比较通过远程医疗(视频访问)完成的就诊比例;或通过面对面就诊进行比较,使用卡方检验。
在研究时间段内,共有 13891 名患者符合纳入标准。其中 12846 名患者在办公室就诊,1048 名患者在远程医疗组就诊。办公室的再入院率为 11.9%,12846 名患者中有 1533 名患者;而远程医疗组的再入院率为 12.1%,1045 名患者中有 126 名患者。在大流行前和研究时间段之间的卡方检验 P 值分别为 0.15 和 0.95。
我们的研究发现,在过渡护理管理(TCM)就诊中,通过办公室和远程医疗就诊的患者的再入院率相当。这项研究的结果支持越来越多的证据,即远程医疗在不影响医疗保健系统 HEDIS 绩效的情况下,提高了质量绩效,同时降低了成本,改善了获取途径。
远程医疗对 HEDIS 绩效的负面影响很小,并且可能与传统的办公室护理一样有效。