Charkviani Mariam, Androga Lagu A, Garg Arvind K, Ramar Priya, Amundson Rachel H, Vaughan Lisa E, Zoghby Ziad, Albright Robert C
Nephrology and Hypertension Division, Mayo Clinic College of Medicine, Rochester, MN.
Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL.
Mayo Clin Proc Innov Qual Outcomes. 2025 Jul 28;9(5):100645. doi: 10.1016/j.mayocpiqo.2025.100645. eCollection 2025 Oct.
To determine whether novel dialysis delivery models, such as telehealth visits combined with face-to-face visits in a hybrid model (telehealth hybrid model), positively influence clinical outcomes and healthcare utilization.
This retrospective cohort study compares the rates of emergency department visits, hospitalizations, and Medicare established hemodialysis quality metrics before and after implementation of a telehealth hybrid model focused among rural populations in regions served by the Mayo Clinic dialysis system between January 1, 2020, to December 31, 2020, versus face-to-face visits alone before implementation of the program from January 1, 2019, to December 31, 2019. In addition, we used a standardized anonymous survey to examine patient perspectives toward the implementation of telehealth at the dialysis units.
No significant differences in health care utilization outcomes (emergency department visits: Incidence rate ratios, 95% CI, 0.87 (0.62-1.22); =.41; hospitalizations: Incidence rate ratios, 95% CI, 0.92 (0.63-1.35); =.68) or clinical outcomes (abnormal laboratory measures) between the telehealth and standard care groups were observed. Patient satisfaction with telehealth was high, with 90% reporting successful video visits.
Our study provides evidence suggesting that the telehealth hybrid model can deliver nephrology care comparable to traditional care models in in-center dialysis without negatively impacting clinical outcomes, health care utilization, or patient satisfaction. Further research is necessary to confirm these results in other settings and to explore the long-term impacts of such hybrid care models.
确定新型透析服务模式，如远程医疗问诊与面对面问诊相结合的混合模式（远程医疗混合模式）是否对临床结局和医疗保健利用产生积极影响。
这项回顾性队列研究比较了2020年1月1日至2020年12月31日梅奥诊所透析系统服务地区农村人口实施远程医疗混合模式前后的急诊科就诊率、住院率以及医疗保险规定的血液透析质量指标，与2019年1月1日至2019年12月31日该项目实施前仅进行面对面问诊的情况进行对比。此外，我们使用标准化匿名调查来了解患者对透析单位实施远程医疗的看法。
在远程医疗组和标准护理组之间，未观察到医疗保健利用结局（急诊科就诊：发病率比，95%置信区间，0.87(0.62 - 1.22); P = 0.41；住院：发病率比，95%置信区间，0.92(0.63 - 1.35); P = 0.68）或临床结局（实验室检查异常）存在显著差异。患者对远程医疗的满意度较高，90%的患者报告视频问诊成功。
我们的研究提供的证据表明，远程医疗混合模式在中心透析中提供的肾病护理可与传统护理模式相媲美，且不会对临床结局、医疗保健利用或患者满意度产生负面影响。有必要进行进一步研究以在其他环境中证实这些结果，并探索此类混合护理模式的长期影响。
