Veldeman Sarah, Martin Tobias, Wüeller Johannes, Czaplik Michael, Follmann Andreas
Department of Anaesthesiology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany.
Home Care Städteregion Aachen gGmbH, Aachen, Germany.
Palliat Med. 2025 Apr;39(4):499-506. doi: 10.1177/02692163251321717. Epub 2025 Feb 28.
Telemedicine in palliative care is advancing to conquer challenges like staff shortages and limited access. Though feasibility and acceptance are proven, the clinical effects of teleconsultations (a nurse on-site consulting with a remote physician) have yet to be studied. The impact on physicians' workload or which patients it suits best, remain unclear.
This study analyses the effect of teleconsultations on physician quota (number of physician-attended home visits divided by total number of home visits) and hospitalizations in specialized outpatient palliative care (SOPC) after 3 years of use in Aachen, Germany.
In a single-center, retrospective cohort study (September 2019-March 2023), clinical data was retrieved from a palliative care provider.
SETTING/PARTICIPANTS: 1756 patients with diseases from all medical disciplines received care during the observation period. By clinicians' choice 384 received teleconsultations, while 1372 did not.
833 teleconsultations were conducted. Telemedicine patients were younger (72.8 ± 12.5 years vs. non-telemedicine 74.4 ± 12.8 years, = 0.011), presented more diagnoses ( < 0.001), while scope of symptoms and diagnoses was equivalent. Telemedicine patients had a longer duration of stay within the SOPC and more home visits. Physician quota in the telemedicine group was lower ( < 0.001). A matched pairs analysis ( = 726) showed no significant difference in hospitalizations.
Telemedicine can reduce physician quota, alleviating personnel shortages while providing time for care-intensive patients and creating capacity for more patients. Telemedicine seems suited for multimorbid, long-term patients. A matched pairs analysis showed no difference in hospitalizations in telemedicine patients.
姑息治疗中的远程医疗正在不断发展，以应对人员短缺和就医机会有限等挑战。尽管已证明其可行性和可接受性，但远程会诊（一名现场护士与远程医生进行会诊）的临床效果尚未得到研究。对医生工作量的影响以及最适合哪些患者，仍不明确。
本研究分析了在德国亚琛使用3年后，远程会诊对专科门诊姑息治疗（SOPC）中医生配额（医生上门访视次数除以总上门访视次数）和住院情况的影响。
在一项单中心回顾性队列研究（2019年9月至2023年3月）中，从一家姑息治疗机构检索临床数据。
设置/参与者：在观察期内，1756名患有各种医学学科疾病的患者接受了护理。根据临床医生的选择，384名患者接受了远程会诊，而1372名患者未接受。
进行了833次远程会诊。接受远程医疗的患者更年轻（72.8±12.5岁，非远程医疗患者为74.4±12.8岁，P = 0.011），诊断更多（P < 0.001），而症状和诊断范围相当。接受远程医疗的患者在SOPC中的住院时间更长，上门访视次数更多。远程医疗组的医生配额较低（P < 0.001）。配对分析（n = 726）显示住院情况无显著差异。
远程医疗可以降低医生配额，缓解人员短缺问题，同时为需要密集护理的患者腾出时间，并为更多患者提供服务。远程医疗似乎适用于患有多种疾病的长期患者。配对分析显示远程医疗患者的住院情况没有差异。
