Hakanen Oskari, Lamminmäki Satu, Torkki Paulus, Tolvi Morag
Faculty of Medicine University of Helsinki Helsinki Finland.
Department of Otorhinolaryngology - Head and Neck Surgery Helsinki University Hospital and University of Helsinki Helsinki Finland.
Laryngoscope Investig Otolaryngol. 2025 Jun 24;10(3):e70184. doi: 10.1002/lio2.70184. eCollection 2025 Jun.
As canceled appointments and undertreated patients generate substantial expenses in healthcare, this study examines whether tonsillectomy candidates assessed via telemedicine-assisted care paths exhibit elevated appointment cancellation rates compared to those evaluated in-person at an outpatient clinic.
At Helsinki University Hospital, a tertiary referral clinic, two telehealth-assisted care paths (virtual visits and a digital care pathway) have been available in recent years to remotely assess patients for tonsillectomy. To evaluate whether preoperative telehealth negatively affects tonsillitis patients' compliance to treatment, we compared cancellation rates of these two e-health care paths as primary outcome measures with the outpatient clinic, which was defined as the control group.
The remote care paths showed the highest rates of cancellation. 25.9% of the digital care pathway patients canceled their care path compared to 6.6% of outpatient clinic patients who canceled appointments ( < 0.01). 29.4% of the digital care pathway patients had an additional remote contact with the clinic preoperatively compared to 18.5% of patients assessed at the outpatient clinic ( = 0.002). Patients assessed remotely were more likely to make an unplanned additional contact than patients seen at the outpatient clinic. No significant differences in canceled surgeries were observed between the cohorts.
Assessing patients for tonsillectomy via a digital care pathway appears to increase cancellations and additional contacts. Therefore, both digital and in-person assessments should remain available for tonsillectomy candidates to accommodate varying patient needs and offset additional costs.
Level 3.
由于取消预约和治疗不足的患者会在医疗保健方面产生大量费用，本研究旨在探讨通过远程医疗辅助护理路径评估的扁桃体切除术候选人与在门诊进行面对面评估的候选人相比，是否有更高的预约取消率。
在赫尔辛基大学医院（一家三级转诊诊所），近年来有两种远程医疗辅助护理路径（虚拟就诊和数字护理路径）可用于对扁桃体切除术患者进行远程评估。为了评估术前远程医疗是否会对扁桃体炎患者的治疗依从性产生负面影响，我们将这两种电子医疗护理路径的取消率作为主要结果指标，与被定义为对照组的门诊进行比较。
远程护理路径的取消率最高。数字护理路径中有25.9%的患者取消了护理路径，而门诊患者中取消预约的比例为6.6%（<0.01）。数字护理路径中有29.4%的患者在术前与诊所进行了额外的远程联系，而在门诊接受评估的患者中这一比例为18.5%（=0.002）。与在门诊就诊的患者相比，通过远程评估的患者更有可能进行计划外的额外联系。各队列之间在取消手术方面未观察到显著差异。
通过数字护理路径对扁桃体切除术患者进行评估似乎会增加取消率和额外联系。因此，对于扁桃体切除术候选人，数字评估和面对面评估都应继续提供，以满足不同患者的需求并抵消额外费用。
3级。
