住院患者电子咨询喘住院改善门诊患者的结果
Linh-An C Tuong1, Allison Ramsey1,2, Sara Patrawala1,2
1Division of Allergy and Immunology, Rochester Regional Health, Rochester, NY, USA.
概括
在喘住院期间的过敏/免疫电子咨询显著减少了全身皮质类固醇的使用和医疗保健的利用. 这种干预措施改善了儿童和成人患者的治疗结果,无论随访状态如何.
科学领域:
- 过敏和免疫学 过敏和免疫学
- 肺部病理学 肺部病理学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 喘恶化通常导致系统性皮质类固醇使用,急诊室访问和住院治疗.
- 在住院喘治疗后的门诊随访护理中经常存在差距.
- 专家护理对于改善喘结果至关重要.
研究的目的:
- 为了评估过敏/免疫学 (A/I) 电子咨询 (e-consult) 的临床影响,用于患有喘恶化住院的患者.
- 评估住院患者A / I电子咨询在改善喘管理和减少医疗保健利用方面的有效性.
主要方法:
- 一个质量改进项目,涉及所有喘入院患者的住院A/I电子咨询.
- 在咨询后的一年内跟踪临床结果.
- 使用描述性统计和对T测试进行数据分析.
主要成果:
- 招募了133名患者,57%为女性,48%为黑人,27%为西班牙裔.
- 在电子咨询之后,住院时间从1.38降至0.42 (p<.0001).
- 紧急诊所/急诊诊所的次数从1.35下降到0.70 (p=.0025),系统性皮质类固醇疗程从2.74下降到1.43 (p<.0001).
结论:
- 对于喘恶化患者的住院A/I电子咨询有效减少了全身皮质类固醇的使用.
- 这种干预措施显著减少了医疗保健的利用率,包括住院和ED/UC访问.
- 在儿童和成人患者中都观察到积极的影响,无论他们是否遵守随访.
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