电话护理作为常规诊所随访的替代品
J Wasson1, C Gaudette, F Whaley
1Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH 03755-3862.
JAMA
|April 1, 1992
概括
替代诊所访问的电话护理减少了医疗服务的使用率和医疗保健成本. 对于更生病的患者来说,这种方法也可以改善健康结果并降低死亡率.
科学领域:
- 主要护理是指初级护理.
- 医疗保健服务研究 医疗服务研究
- 老年医学 老年医学
背景情况:
- 管理老年人的慢性疾病往往涉及到频繁的诊所访问.
- 优化医疗保健供应以减少利用率和成本是初级医疗保健的一个关键挑战.
研究的目的:
- 评估假设,用临床医生发起的电话护理取代一些亲临诊所访问,将减少医疗服务利用率,而不会对患者健康产生负面影响.
- 评估电话照顾在老年男性人口中的经济影响和潜在的健康益处.
主要方法:
- 在一家初级保健机构进行了一项随机试验,涉及497名54岁及以上的男性.
- 干预组接受了电话照顾,包括加倍的随访间隔和定期的电话联系,而对照组接受了通常的照顾.
- 主要结局指标包括医疗服务的使用率和患者在2年的随访期间的健康状况.
主要成果:
- 电话护理患者的总诊所访问减少了19%,药物使用显著减少 (14%),住院和住院日数显著减少 (28%).
- 在电话护理组中,重症监护室 (ICU) 的日数减少了41%.
- 预计医疗保健支出在电话护理患者中降低了28%,最初健康状况良好或不佳的患者节省了更多.
结论:
- 替换特定诊所访问的电话护理是一种有效的策略,可以显著降低医疗服务利用率和医疗保健成本.
- 在更严重的患者中,电话护理可能会改善身体功能,并可能降低死亡率.
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