在儿童和青少年中使用虚拟护理和急救部门
Gabrielle Freire1,2,3, Eyal Cohen1,2,3,4,5,6, Therese A Stukel4,5
1The Hospital for Sick Children, Toronto, Canada.
JAMA network open
|February 3, 2026
概括
3个月及以上的患病儿童的虚拟初级保健访问与急诊室 (ED) 使用量略有增加有关,特别是对于低急性访问. 建议仔细考虑儿童急性疾病的虚拟护理.
科学领域:
- 儿科健康 儿科健康
- 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:
- 虚拟护理的使用急剧增加,但其对儿科急诊室 (ED) 使用的影响尚不清楚.
- 了解初级保健访问模式对随后的ED访问的影响对于优化急性疾病儿童的医疗保健提供至关重要.
研究的目的:
- 确定初级保健病患访问的模式 (面对面或虚拟) 是否与0-17岁儿童随后的急诊室 (ED) 使用有关.
- 分析虚拟初级保健与各种ED访问结果之间的关联,包括导致住院或死亡的结果,以及高或低急性访问.
主要方法:
- 一项基于人口的队列研究,利用加拿大安大略省的行政数据,包括超过260万名儿童 (0-17岁) 在2020年9月至2024年3月期间进行初级保健病诊.
- 儿童按年龄分类 (<3个月,3个月至<2岁,2至17岁),并根据医生计费代码确定了初级保健病诊模式.
- 用年龄分层的多变量后勤通用估计方程模型来评估虚拟与面对面的初级保健访问和随后的ED使用之间的关联,以多个混因素进行调整.
主要成果:
- 虚拟访问占所有初级保健病患访问的27.6%.
- 3个月至<2岁和2至17岁的儿童在虚拟初级护理后后续ED访问的调整后风险增加,相比于面对面的访问 (ARR分别为1.49和1.19).
- 虚拟护理与导致住院或死亡的急救诊所风险较低,高急性急救诊所风险相似,以及3个月及以上儿童低急性急救诊所风险更高. 在3个月以下的婴儿中,无论访问方式如何,都显示出类似的ED访问风险.
结论:
- 虽然不常见,但初级保健病患访问后的急诊室访问在为3个月及以上的儿童进行虚拟咨询后稍微更为常见,特别是在低急性问题上.
- 这些发现表明,需要明智地使用虚拟初级保健来管理急性儿童疾病,平衡便利性和对ED利用的潜在影响.
- 可能需要进一步的研究,以探索虚拟初级保健后增加低急性ED访问的具体原因,并完善儿科患者的虚拟护理指南.
相关概念视频
01:27Emerging Adulthood
696
Jeffrey Arnett's concept of emerging adulthood offers a framework to understand the unique developmental stage between adolescence and full-fledged adulthood, generally from ages 18 to 25. This period is marked by extensive exploration and shifts in identity, relationships, and career choices, a process known in psychology as role experimentation. Emerging adulthood reflects the evolving cultural expectations surrounding adulthood and the dynamic process of personal transformation during...
696
01:20Virtual Work
1.4K
The principle of virtual work states that if a body is in static and dynamic equilibrium, then the sum of all the virtual work done by all external forces and couple moments for any given virtual displacement must be zero.
In static equilibrium, a body can experience an imaginary or virtual movement, such as displacement or rotation. The virtual work done by a force is equal to the dot product of force and virtual displacement in the direction of the force. When it comes to virtually rotating a...
In static equilibrium, a body can experience an imaginary or virtual movement, such as displacement or rotation. The virtual work done by a force is equal to the dot product of force and virtual displacement in the direction of the force. When it comes to virtually rotating a...
1.4K
01:30Introduction Cardiac Emergencies
373
Cardiac emergencies are critical situations involving the heart that require immediate medical intervention to prevent severe complications or death. These emergencies often arise from underlying heart conditions that impair the heart's ability to function correctly.Types of Cardiac EmergenciesThe most common types of cardiac emergencies include Acute Coronary Syndrome (ACS), myocardial infarction (MI), cardiac arrest, and heart failure.Acute Coronary Syndrome (ACS)Acute Coronary Syndrome (ACS)...
373
01:21Interdisciplinary Care: The Health Care Team-I
2.7K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care.
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution...
2.7K
01:18Interdisciplinary Care: The Health Care Team-II
2.3K
An interdisciplinary team includes many healthcare professionals working together and utilizing their skills, knowledge, and expertise to provide holistic and quality patient care. Here are a few more healthcare professionals.
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
Physical Therapist
A physical therapist (PT) aims to restore function or prevent additional impairment in a patient following an injury or disease. Massage, heat, cold, water, sonar waves, exercises, and electrical stimulation are some treatments used by PTs to treat...
2.3K
01:13Principle of Virtual Work: Problem Solving
1.7K
The principle of virtual work is an essential concept in the field of mechanics and engineering. This is used to solve problems related to the equilibrium of a structure or system. It is based on the assumption that if a system is in equilibrium, the work done by all the forces during a virtual displacement is zero. This principle is applied by considering virtual displacements of the system and the corresponding work done by internal and external forces.
To apply the principle of virtual work,...
To apply the principle of virtual work,...
1.7K