Redeker Anne-Catherine, Martin Tobias, Veldeman Sarah, Pereira Carina Barbosa, Kunczik Janosch, Czaplik Michael, Follmann Andreas
Faculty of Medicine, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
Docs In Clouds Telecare GmbH, Vaalser Straße 460, 52074, Aachen, Germany.
BMC Geriatr. 2025 Sep 8;25(1):687. doi: 10.1186/s12877-025-06244-6.
Hospital admissions occur frequently in nursing homes and are often preventable. Inappropriate hospitalisations due to nursing home-sensitive conditions pose significant risks to residents, place additional strain on emergency departments and hospitals, and thus lead to substantial healthcare costs. In light of demographic changes- characterised by an aging and increasingly multimorbid nursing home population- combined with ubiquitous lack of health care professionals, new strategies are urgently needed to ensure adequate medical care in nursing homes. Telemedicine presents a promising and innovative solution, particularly for rural regions, to improve access to timely medical attention. In this study, we evaluated whether the implementation of regular televisits, in addition to on-site visits, can help decrease unplanned hospitalisations.
In 2021, a nursing home in rural Germany introduced televisits with a cooperating general practitioner. Data on unplanned hospital admissions was collected for the years 2021/22 and 2018/19, the latter serving as a pre-intervention comparison. Hospital admissions were then compared between the two time periods, as well as between residents of 2021/22 who did or did not receive regular televisits.
Baseline characteristics were comparable between residents of 2018 and 2021, as well as between residents in the telemedical care and the control group. Unplanned hospital admissions significantly decreased (P <.0001) after implementation of regular televisits. Furthermore, a significantly lower (P =.04) number of hospital admissions was noted among residents in 2021/22 who received additional regular televisits, compared to the control group of residents that only received regular on-site visits.
Implementing regular televisits in the nursing home setting reduced the number of hospital admissions. This is most likely due to more frequent medical assessment, enabling early detection and timely management of deteriorations. By preventing unnecessary hospital admissions residents were spared the physical and psychological burdens connected with emergency transfers and protected from hospital-associated risks. On top of enhancing quality of care for the residents, televisits implementation in nursing homes can contribute to decrease strain on emergency services and hospitals.
Not applicable, as no health-related intervention, modifying biomedical outcome or health-related measures in patients, took place.
养老院中频繁发生住院情况，且很多时候是可以预防的。因养老院敏感状况导致的不适当住院对居民构成重大风险，给急诊科和医院带来额外压力，进而导致大量医疗费用。鉴于人口结构变化——以养老院人口老龄化和多病共存情况日益增多为特征——再加上普遍缺乏医疗保健专业人员，迫切需要新策略来确保养老院提供充足的医疗服务。远程医疗提供了一个有前景的创新解决方案，特别是对于农村地区，有助于改善获得及时医疗护理的机会。在本研究中，我们评估了除现场就诊外，实施定期视频问诊是否有助于减少非计划住院情况。
2021年，德国农村的一家养老院引入了与合作全科医生的视频问诊。收集了2021/22年和2018/19年非计划住院的数据，后者作为干预前的对照。然后比较两个时间段之间以及2021/22年接受或未接受定期视频问诊的居民之间的住院情况。
2018年和2021年居民之间以及远程医疗护理组和对照组居民之间的基线特征具有可比性。实施定期视频问诊后，非计划住院情况显著减少（P <.0001）。此外，与仅接受定期现场就诊的对照组居民相比，2021/22年接受额外定期视频问诊的居民住院次数显著更低（P = 0.04）。
在养老院环境中实施定期视频问诊减少了住院次数。这很可能是由于更频繁的医疗评估，能够早期发现并及时处理病情恶化情况。通过防止不必要的住院，居民避免了与紧急转运相关的身体和心理负担，并免受医院相关风险的影响。除了提高居民的护理质量外，在养老院实施视频问诊有助于减轻急诊服务和医院的压力。
不适用，因为未对患者进行与健康相关的干预、改变生物医学结果或健康相关措施。
