Fagen Julia, Talarico Robert, Mercier Olivia, Horth Chantal, Souza Sara C S, Muldoon Katherine Anne, Sampsel Kari
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
CJEM. 2025 Jan;27(1):53-63. doi: 10.1007/s43678-024-00783-4. Epub 2025 Jan 6.
The primary objective was to evaluate the effectiveness of telemedicine for improving clinical follow-up for survivors of sexual assault and intimate partner violence after an emergency department (ED) visit. The Sexual Assault and Partner Abuse Care Program (SAPACP) is an ED-based clinic for survivors of sexual assault/intimate partner violence. Virtual Visit, a telemedicine platform, was introduced at SAPACP in January 2020, allowing patients to attend follow-up virtually.
This is a seven-year analysis of sexual assault/intimate partner violence cases presenting to an ED from 1 Jan 2015 to 31 Mar 2022. Interrupted time series and segmented linear regression models with a first lag autoregressive covariance structure were used to analyze follow-up rates post-Virtual Visit and to predict a counterfactual trend.
Between 2015 and 2022, there were 3317 sexual assault/intimate partner violence case visits, with 2406 visits being pre-Virtual Visit (1 Jan 2015-31 Dec 2019) and 911 visits post-Virtual Visit (1 Jun 2020-31 Mar 2022). Within the 911 post-Virtual Visit visits, 315 (35%) had virtual follow-ups, 291 (32%) had in-person follow-ups, and 305 (33%) did not return for follow-up. Post-Virtual Visit, there was an immediate 10% increase in the proportion of overall follow-ups while accounting for pre-Virtual Visit trends, which was sustained over two years. The proportion of overall follow-up pre-Virtual Visit was 48% (95% CI: 46.0-50.0%), and was 70.0% (95.0% CI: 67.0-73.0%) post-Virtual Visit. Looking at sub-groups, follow-up for sexual assault cases reached 75.0% (95% CI: 71.0-78.0%) and physical/verbal cases reached 64.0% (95% CI: 60.0-69.0%) post-Virtual Visit.
The implementation of Virtual Visit led to an immediate 10% increase in the proportion of overall follow-ups, which was sustained over a two-year period, while accounting for pre-Virtual Visit trends. These findings indicate that telemedicine can help improve clinical follow-up among survivors of sexual assault/intimate partner violence.
主要目标是评估远程医疗对改善急诊科就诊后性侵犯和亲密伴侣暴力幸存者临床随访的有效性。性侵犯和伴侣虐待护理项目（SAPACP）是一家设在急诊科的针对性侵犯/亲密伴侣暴力幸存者的诊所。2020年1月，远程医疗平台“虚拟就诊”在SAPACP推出，使患者能够进行虚拟随访。
这是一项对2015年1月1日至2022年3月31日期间到急诊科就诊的性侵犯/亲密伴侣暴力案件进行的为期七年的分析。采用带有一阶滞后自回归协方差结构的中断时间序列和分段线性回归模型来分析“虚拟就诊”后的随访率，并预测反事实趋势。
2015年至2022年期间，有3317次性侵犯/亲密伴侣暴力案件就诊，其中2406次就诊发生在“虚拟就诊”之前（2015年1月1日至2019年12月31日），911次就诊发生在“虚拟就诊”之后（2020年6月1日至2022年3月31日）。在911次“虚拟就诊”后的就诊中，315次（35%）进行了虚拟随访，291次（32%）进行了面对面随访，305次（33%）未返回进行随访。在考虑“虚拟就诊”前趋势的情况下，“虚拟就诊”后总体随访比例立即提高了10%，并持续了两年。“虚拟就诊”前总体随访比例为48%（95%CI：46.0-50.0%），“虚拟就诊”后为70.0%（95.0%CI：67.0-73.0%）。按亚组来看，性侵犯案件的随访率在“虚拟就诊”后达到75.0%（95%CI：71.0-78.0%），身体/言语暴力案件的随访率达到64.0%（95%CI：60.0-69.0%）。
“虚拟就诊”的实施使总体随访比例立即提高了10%，在考虑“虚拟就诊”前趋势的情况下，这一比例持续了两年。这些发现表明，远程医疗有助于改善性侵犯/亲密伴侣暴力幸存者的临床随访。
