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[从用户角度看远程医疗、住院-门诊护理概念改善医疗质量的潜力——TELnet@NRW研究的接受度分析]

[Potential of a Telemedical, Inpatient-Outpatient Care Concept to Improve the Quality of Healthcare from the User's Perspective - An Acceptance Analysis of the TELnet@NRW Study].

作者信息

Schmidhuber Carolin, Strotbaum Veronika, Beckers Rainer, Hempen Annette, Benstöm Carina, Marx Gernot, Dohmen Sandra

机构信息

Klinik für Operative Intensivmedizin und Intermediate Care, Uniklinik RWTH Aachen, Aachen, Germany.

Gesundheitscampus 10, Landeszentrum Gesundheit Nordrhein-Westfalen, Bochum, Germany.

出版信息

Gesundheitswesen. 2024 Nov;86(11):723-729. doi: 10.1055/a-2348-3136. Epub 2024 Aug 6.

Abstract

OBJECTIVE

The aim of this study was to measure the acceptance of a telemedical, inpatient-outpatient care concept by physicians, patients and the relatives of patients. Based on a quantitative survey of acceptance, both the potential and success factors influencing the use of telemedicine were to be highlighted.

METHODS

The TELnet@NRW study is a national, multicenter, cluster-randomized study in stepped-wedge design conducted from February 2017 to January 2020 for the purpose of documenting changes in the quality of care through telemedicine in an inpatient-outpatient network. Consultations were focused on intensive care medicine and infectious diseases. This current study used questionnaires for specific groups of patients to determine acceptance of the telemedical care concept practiced in the main study. The survey was anonymously conducted once in either digital or paper-based form during the reporting period.

RESULTS

The answers of 126 questionnaires from physicians and 1686 questionnaires from patients and their relatives were evaluated. The physicians of both sectors attributed high potential (up to 88.4%) for telemedicine to improve guideline-adherent treatment. A trustworthy and appreciative communication during the telemedical consultation represented a positively reinforcing success factor. The additional workload generated by telemedicine inhibited acceptance, especially in the inpatient sector. A continuation of telemedicine beyond the end of the project was supported by the majority of surveyed physicians (inpatient 60.6%, outpatient 82.1%) as well as in patients and their relatives (inpatient 79.7%, outpatient 57.4%) in both sectors.

CONCLUSION

There is widespread acceptance of telemedical, inpatient-outpatient care concepts among physicians, patients and their relatives. Low-effort processes and user-centered technology are crucial to increase the rate of use. Telemedicine has the potential to improve the quality of care and can serve as a robust component of sustainable healthcare in Germany.

摘要

目的

本研究旨在衡量医生、患者及其家属对远程医疗的住院-门诊护理概念的接受程度。基于对接受程度的定量调查,突出影响远程医疗使用的潜在因素和成功因素。

方法

TELnet@NRW研究是一项全国性、多中心、整群随机研究,采用阶梯楔形设计,于2017年2月至2020年1月进行,目的是记录住院-门诊网络中通过远程医疗实现的护理质量变化。会诊主要集中在重症医学和传染病方面。本项研究使用针对特定患者群体的问卷来确定对主要研究中实践的远程医疗护理概念的接受程度。在报告期内,以数字或纸质形式对调查进行了一次匿名调查。

结果

对126份医生问卷和1686份患者及其家属问卷的答案进行了评估。两个科室的医生都认为远程医疗在改善遵循指南治疗方面具有很高的潜力(高达88.4%)。远程医疗会诊期间值得信赖且相互尊重的沟通是一个积极的成功因素。远程医疗产生的额外工作量抑制了接受程度,尤其是在住院科室。大多数接受调查的医生(住院科室60.6%,门诊科室82.1%)以及两个科室的患者及其家属(住院科室79.7%,门诊科室57.4%)都支持在项目结束后继续开展远程医疗。

结论

医生、患者及其家属对远程医疗的住院-门诊护理概念普遍接受。低工作量流程和以用户为中心的技术对于提高使用率至关重要。远程医疗有潜力改善护理质量,并可成为德国可持续医疗保健的有力组成部分。

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