心脏植入式电子设备患者随访:对美国实践的评估
David Slotwiner1, Jiani Yu1, Manyao Zhang1
1Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Heart rhythm
|October 13, 2024
概括
大多数新心脏植入式电子设备的患者在第一年内接受了推的办公室内访问,但随后的随访护理下降了. 远程监测率较低,老年,非白人或低收入患者获得的护理不那么一致.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 医疗器械技术 医疗器械技术
背景情况:
- 专家共识建议每年对心脏植入式电子设备 (CIED) 患者进行室内评估和远程监测.
- 遵守这些建议对于最佳的患者管理和设备功能至关重要.
研究的目的:
- 评估治疗与2015年共识建议对接受新CIEDs的患者的一致性.
- 确定影响Medicare受益人后续护理模式的因素.
主要方法:
- 分析了2015年10月至2020年12月期间获得新CIED的211,346名医疗保险受益人.
- 办公室内访问率和远程监控频率的评估.
- 评估与随访护理相关的患者人口统计数据.
主要成果:
- 77.8%的患者在植入后16周内进行了办公室内访问; 85.9%在第一年内.
- 在随后的几年里,办公室内访问率下降,每两年仅有64.2%.
- 远程监控的频率很少:在91天内14.7%,在第一年每91天4.4%.
- 年龄较大 (≥85岁),非白人种族和收入较低与减少办公室访问率有关.
结论:
- 虽然最初的办公室内随访是常见的,但在CIED植入后的晚年,坚持减弱.
- 远程监控的利用远远落后于专家共识建议.
- 在护理方面存在差异,脆弱的患者群体不太可能接受推的随访.
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