虚拟心力衰竭咨询:为脆弱,多病症和远程患者提供服务
Bethany Wong1,2, Joseph McCambridge2, Matthew Barrett2
1School of Medicine, University College Dublin, Dublin, Ireland bethany.wong@ucdconnect.ie.
Open heart
|August 11, 2023
概括
心力衰竭虚拟咨询 (VC) 显著减少了老年,脆弱患者的入院转诊. 这种电子健康工具提高了全科医生评估质量,提高了心力衰竭 (HF) 的诊断和管理.
科学领域:
- 心脏病学 心脏病学
- 电子健康 电子健康
- 一般实践一般实践
背景情况:
- 心力衰竭 (HF) 虚拟咨询 (VC) 是一个电子卫生工具,用于对全科医生 (GPs) 提供关于HF诊断和管理的同行专家建议.
- 该研究调查了VC对转诊率和GP评估质量的影响,以及患者的脆弱性和并发性疾病等特征.
研究的目的:
- 评估虚拟咨询 (VC) 服务对心力衰竭 (HF) 管理的有效性.
- 评估VC对医院转诊率和全科医生 (GP) 评估质量的影响.
- 描述利用VC服务的患者,包括他们的脆弱性,年龄和并发症状况.
主要方法:
- 一项前性观察性研究,收集了2015年至2021年间1681次虚拟咨询 (VC) 的数据.
- 数据包括人口统计数据,并发病率,脆弱性 (临床脆弱性得分 - CSF),转诊指示和医生对没有VC的管理的反应.
- 患者的特征与参加心力衰竭病房 (HFU) 的对照组进行了比较.
主要成果:
- 虚拟货币咨询主要服务于偏远地区 (75%),并显示重新讨论案件增加 (0%至34%).
- 冠状病毒患者比HFU患者更年长 (76.2 vs 73.1年),更脆弱 (CSF 3.8 vs 3),多病症 (7.1 vs 3.8并发症) 较多.
- 到2021年,VC将医院转诊从93%降至9%,医生使用自然尿素 (NP) (0%至63%) 和TTE (0%至69%) 增加.
结论:
- 风险投资服务有效地支持对怀疑心力衰竭 (HF) 的老年,脆弱患者的管理.
- 维生素C显著减少了对医院转诊的需求,可能使得早期诊断和管理成为可能.
- 该服务提高了社区HF评估的质量,其证据是GP越来越多地使用NP和TTE等诊断工具.
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