一个随机对照试验后ICU远程医疗保健模型 (WFIT) 的随机对照试验
Rita N Bakhru1,2, Lori Flores3, J Maycee Cain3
1Pulmonary, Critical Care, Allergy, and Sleep, Medical University of South Carolina, Charleston, South Carolina.
概括
一个在重症监护室 (ICU) 后的远程医疗护理模型没有显示出明显的成本效益优势,而不是重症幸存者的标准护理. 虽然患者报告对外医院的急诊室访问增加了,但整体医疗保健支出和再接收仍然相似.
科学领域:
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
- 数字健康干预措施 数字健康干预措施
背景情况:
- 严重疾病的幸存者面临着长期不良结果的重大风险,包括再入院,生活质量下降和死亡率.
- 重症监护病房 (ICU) 后的康复为缓解这些长期影响的干预提供了一个关键的窗口.
- 远程医疗模式为ICU出院后的结构化后续护理提供了一个潜在的途径.
研究的目的:
- 评估ICU后远程医疗保健模型的成本效益.
- 评估这种远程医疗干预措施在改善重症幸存者的治疗结果方面的临床有效性.
主要方法:
- 一个单中心随机对照试验,涉及400名患有败血症和/或急性呼吸衰竭的ICU患者.
- 干预组在ICU出院后定期接受远程医疗访问,并在六个月内获得必要的支持.
- 对照组接受了标准的护理,主要结果是成本效益.
主要成果:
- 与对照组相比,在急诊室和住院的总体医疗保健支出在远程医疗组中没有显著的增量净收益.
- 患者报告的外医院急诊室访问量在远程医疗干预组显著高 (2.43对0.97每月100名患者;P=0.03).
- 干预组和对照组之间,重入院,死亡率,生活质量和患者满意度等关键结果是相似的.
结论:
- 在ICU后的远程医疗干预,虽然显示了变化,但与标准护理相比,在成本效益方面没有提供明显的增量净收益.
- 该研究强调,需要进一步研究优化远程医疗干预措施,以便在ICU后恢复.
- 该试验已在clinicaltrials.gov (NCT04576065) 上注册.
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