White Malin, Ahmed Mian W, Lyons Emma, Elliott Ffion, Chatterji Ritwick, Choudhury Yasmin, Joshi Arun, Marshall Ben
Pulmonary Medicine, Southampton General Hospital NHS Foundation Trust, Southampton, GBR.
Respiratory Medicine, Southampton General Hospital NHS Foundation Trust, Southampton, GBR.
Cureus. 2025 Jun 12;17(6):e85892. doi: 10.7759/cureus.85892. eCollection 2025 Jun.
Background Follow-up after pneumonia is essential to detect underlying malignancies and identify residual complications. In 2013, the University Hospitals of Southampton NHS Foundation Trust implemented a novel virtual pneumonia clinic (VPC) to reduce outpatient burden while maintaining clinical standards by providing remote consultant-led follow-up for patients with pneumonia. This study reviews the service a decade after its inception. Methods We conducted a retrospective analysis of all referrals to the VPC between January 2022 and January 2023. Data on demographics, referral source, imaging outcomes, time to follow-up, and final diagnoses were collected. Patients were stratified by age and smoking status, and outcomes such as attendance, residual abnormalities, and diagnostic escalation were analysed. Results A total of 891 patients were referred during the 12 months, representing a threefold increase since the service's inception. Overall, 78.0% attended their convalescent chest X-ray (CXR), with the highest yield of abnormalities seen in patients over 80. Residual radiographic abnormalities were identified in 6.6% of attendees, including lung cancer, pneumonia-related scarring, pleural effusion, and bronchiectasis. The mean time to follow-up CXR was 51.0 days (interquartile range (IQR): 35-63). Referrals were predominantly from respiratory and emergency teams. Based on these findings, referral criteria have been refined to target patients over 50 or those with persistent symptoms or respiratory risk factors. Discussion The VPC model has demonstrated both clinical efficacy and operational efficiency. Consultant time was reduced by 92%, with an estimated per-patient cost saving of £200. Broader NHS and international evidence support virtual models in reducing hospital utilisation, environmental impact, and increasing patient satisfaction. Results The VPC continues to provide a scalable, sustainable model of care, combining diagnostic vigilance with outpatient efficiency. Our findings support replication across other NHS trusts and healthcare systems seeking to enhance post-discharge follow-up while managing resources effectively.
肺炎后的随访对于发现潜在恶性肿瘤和识别残留并发症至关重要。2013年，南安普敦大学医院国民保健服务基金会信托基金实施了一项新型虚拟肺炎诊所（VPC），通过为肺炎患者提供由顾问远程主导的随访，在维持临床标准的同时减轻门诊负担。本研究回顾了该服务开展十年后的情况。方法：我们对2022年1月至2023年1月期间所有转诊至VPC的病例进行了回顾性分析。收集了人口统计学、转诊来源、影像结果、随访时间和最终诊断等数据。患者按年龄和吸烟状况分层，并分析了诸如就诊率、残留异常和诊断升级等结果。结果：在这12个月期间，共有891名患者被转诊，自该服务启动以来增加了两倍。总体而言，78.0%的患者进行了康复期胸部X光检查（CXR），80岁以上患者的异常检出率最高。在6.6%的就诊患者中发现了残留的影像学异常，包括肺癌、肺炎相关瘢痕、胸腔积液和支气管扩张。随访CXR的平均时间为5天（四分位间距（IQR）：35 - 63）。转诊主要来自呼吸科和急诊科。基于这些发现，转诊标准已得到完善，以针对50岁以上或有持续症状或呼吸风险因素的患者。讨论：VPC模式已证明具有临床疗效和运营效率。顾问时间减少了92%，估计每位患者节省成本200英镑。更广泛的英国国民保健服务体系和国际证据支持虚拟模式在降低医院利用率、环境影响和提高患者满意度方面的作用。结果：VPC继续提供一种可扩展、可持续的护理模式，将诊断警惕性与门诊效率相结合。我们的研究结果支持在其他寻求加强出院后随访并有效管理资源的英国国民保健服务信托基金和医疗系统中推广。
