虚拟护理结果的专业特定评估:回顾性质量和安全分析 (S-EVOQUe)
Shawn Mondoux1,2,3, Frank Battaglia1, Anastasia Gayowsky4
1Department of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
PLOS digital health
|January 29, 2025
概括
疫情期间的虚拟护理访问与面对面的访问相比,显示了类似或更好的短期患者结果. 这项研究没有发现任何证据表明虚拟护理在短期内比面对面的护理更不安全.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 传染病流行病学 传染病流行病学
背景情况:
- 随着SARS-CoV-2大流行,医疗保健的快速转变变为必需,人们越来越依赖虚拟医疗.
- 了解虚拟与实体访问的安全性和有效性的比较对于医疗保健政策至关重要.
- 门诊护理实践显著适应,促使对不同护理模式的患者结果进行分析.
研究的目的:
- 在SARS-CoV-2大流行期间,将虚拟护理和面对面访问之间的7天和30天患者结果进行比较.
- 评估医疗保健资源的短期安全性和利用率,以评估虚拟护理与亲临的门诊护理.
- 为医疗保健政策提供基于证据的见解,以了解虚拟护理的作用.
主要方法:
- 分析了来自安大略省省级数据库的行政数据,用于大流行期间的门诊护理访问.
- 使用患者特征对虚拟护理访问与实体访问进行匹配比较 (在20%的随机样本上:1:1匹配).
- 多变量逻辑回归用于比较结果,包括复查,急诊室访问,住院/ICU入院,手术和7天和30天死亡率,使用99%的置信区间.
主要成果:
- 分析了930多万次访问,其中70%以上涉及全科医生.
- 在大多数专科中,亲自看病的患者有更高的复诊率,急诊室访问率,住院率,ICU使用率和死亡率.
- 很少有例外,但总体而言,短期结果并没有表明虚拟护理的安全性低于面对面的护理.
结论:
- 短期结果表明,虚拟护理是面对面访问的安全替代方案,一些指标显示虚拟护理的结果更好.
- 在面对面的访问中,较高的不良事件发生率可能与病情更严重的患者被分离到面对面的接触有关.
- 研究结果支持将虚拟护理纳入医疗保健的持续整合和政策考虑.
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