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远程患者监测平台对全髋关节或膝关节置换术后结局的影响。

Impact of a Remote Patient Monitoring Platform on Outcomes Following a Total Hip or Knee Arthroplasty.

作者信息

Chahal Simrun, Siddiqui Rabail, Puskas Liam, Littlefield Shalyn, Naeem Lahama, Fanti Caroline, Cullinan Claude, Droll Kurt, Puskas David, Marion Travis E

机构信息

Clinical Research Services Department, Thunder Bay Regional Health Research Institute, Thunder Bay, ON, Canada.

Lakehead University, Thunder Bay, ON, Canada.

出版信息

Arthroplast Today. 2024 Jun 4;27:101415. doi: 10.1016/j.artd.2024.101415. eCollection 2024 Jun.

Abstract

BACKGROUND

The coronavirus pandemic highlighted the need for remote patient monitoring to deliver and provide access to patient care and education. A mobile-based app providing interactive tools for patient education and monitoring was piloted at Thunder Bay Regional Health Sciences Centre (TBRHSC) in November 2020. We aimed to examine the platform's impact on postoperative length of stay, hospital readmissions, and emergency department (ED) visits 60 days postsurgery in total hip and knee arthroplasty patients in Northwestern Ontario.

METHODS

Data were assessed from patients undergoing primary total hip or knee arthroplasties at TBRHSC from March 1, 2020, to February 28, 2022. Patients were divided into 2 cohorts based on enrollment with the mobile-based app (SeamlessMD). Statistical differences in outcomes were determined using Mann-Whitney or χ tests. An odds ratio was calculated for ED visits.

RESULTS

Patients enrolled in the mobile-based app had statistically lower length of stay ( = 7779.0, < .001) and fewer ED visits (χ  = 5.570,  = .018) than patients not enrolled in the program. Patients not enrolled had 2.31 times greater odds of visiting the ED postsurgery (odds ratio = 0.432, 95% confidence interval = 0.213-0.877,  = .022). There were no statistical differences found in readmission rates.

CONCLUSIONS

The implementation of the mobile-based app at TBRHSC showed its potential value as a tool to reduce costs in the healthcare system and improve patient outcomes. Consequentially, more formal studies are required to elucidate the magnitude of this effect.

摘要

背景

冠状病毒大流行凸显了远程患者监测对于提供患者护理和教育的必要性。2020年11月,在桑德贝地区卫生科学中心(TBRHSC)试点了一款基于移动设备的应用程序,该程序提供用于患者教育和监测的交互式工具。我们旨在研究该平台对安大略省西北部全髋关节和膝关节置换术患者术后住院时间、再次入院情况以及术后60天内急诊就诊情况的影响。

方法

评估了2020年3月1日至2022年2月28日在TBRHSC接受初次全髋关节或膝关节置换术患者的数据。根据是否注册使用基于移动设备的应用程序(SeamlessMD)将患者分为两个队列。使用曼-惠特尼检验或χ²检验确定结果的统计学差异。计算急诊就诊的比值比。

结果

与未注册该程序的患者相比,注册使用基于移动设备应用程序的患者住院时间在统计学上显著缩短(Z = 7779.0,P <.001),急诊就诊次数更少(χ² = 5.570,P =.018)。未注册的患者术后急诊就诊的几率高2.31倍(比值比 = 0.432,95%置信区间 = 0.213 - 0.877,P =.022)。再次入院率没有统计学差异。

结论

TBRHSC实施基于移动设备的应用程序显示出其作为降低医疗系统成本和改善患者结局工具的潜在价值。因此,需要更正式的研究来阐明这种效果的程度。

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