转变过渡期护理:通过在家护理计划提前出院
Shawn M Doss1, Brad Bergum2, Lauren Hopkins2
1Medical College of Georgia, Augusta, GA, USA.
概括
在家护理 (CaH) 计划中,使用远程医疗提前出院,显示了类似的30天再入院率,但显著减少了住院时间和费用. 需要进一步的研究来优化这种创新的远程医疗方法的患者选择.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 数字健康数字健康
- 患者的治疗结果.
背景情况:
- 高的住院再接收率和资源利用率带来了重大挑战.
- 从医院到家庭的过渡需要有效的出院后支持.
- 远程医疗为早期出院后的患者管理提供了潜在的解决方案.
研究的目的:
- 评估基于远程医疗的家庭护理 (CaH) 计划对30天再入院的影响.
- 评估CaH对住院时间 (LoS) 的影响.
- 为了确定CaH对医疗保健总费用的影响.
主要方法:
- 追溯队列研究,将CaH与标准住院护理进行比较.
- 该项目涉及远程医疗支持和医疗保健专业人员的持续监测.
- 分析包括2866个入院病例,其中215个是CaH,2651个是对照组.
主要成果:
- 30天的再入院率是可比的:CaH为11.2%,标准护理为12.8% (P = .57).
- CaH显著降低了LoS (4.7与7.7天相比;P<.001) 和总费用 (54,491美元与84,245美元相比;P<.001).
- 虽然再接纳HRs支持CaH,但它们没有达到非劣势差额 (调整后HR,0.82).
结论:
- 该CaH计划有效地减少了LOS和成本,而没有增加再接收.
- 该研究没有达到其预定义的反录取的非劣势差额.
- 未来的研究应该完善患者选择,并探索特定疾病的远程医疗协议,以便提前出院.
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