在心力衰竭患者中使用远程治疗治疗的决定因素
Aleesha Kainat1, Bradley Very2, Abu Hurera3
1Department of Internal Medine, University of Pittsburgh Medical Center, Mercy, Pittsburgh, Pennsylvania, USA.
Journal of palliative medicine
|November 10, 2025
概括
远程医疗改善了心力衰竭 (HF) 患者的息治疗 (PC) 准入,特别是年轻人和患有更多并发症的人. 然而,社会经济因素,如较高的区域贫困指数限制了访问,突出了远程息护理咨询 (远程PCC) 使用的差异.
科学领域:
- 心脏病学 心脏病学
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
- 远程医疗远程医疗
背景情况:
- 2022年ACC/AHA/HFSA指南强调在心力衰竭 (HF) 管理中整合息治疗 (PC).
- 远程医疗在改善HF患者的PC接入方面的作用正在调查中.
- 影响HF患者使用远程息护理咨询 (tele-PCC) 的因素尚不清楚.
研究的目的:
- 确定与住院HF患者中远程PCC利用相关的患者级因素.
- 在大型医疗保健系统中分析远程PCC使用的预测因素.
主要方法:
- 对31,055名高温患者 (2017-2022) 的回顾性横截面观察性研究.
- 多变量后勤回归确定了远程PCC利用的预测因素.
- 使用曲线下的面积 (AUC) 评估模型的准确性.
主要成果:
- 较年轻的患者 (<50岁) 和查尔森并发症指数得分较高的患者更有可能使用远程PCC.
- 较高的区域贫困指数 (ADI) 评分,接近三级医院和COVID-19前时代的护理与较低的远程PCC利用有关.
- 预测模型显示出强大的准确性 (AUC = 0.8996).
结论:
- 远程PCC的使用率在年轻患者中更高,那些具有更大的并发症负担的人,以及在后流行时代.
- 社会经济因素,如高的ADI,仍然是远程PCC访问的障碍.
- 远程医疗对扩大对HF患者的PC交付充满希望,但需要进一步关注公平获取.
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