Clinical effectiveness and cost analysis of patient referral by videoconferencing in orthopaedics
Clinical effectiveness and cost analysis of patient referral by videoconferencing in orthopaedics
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DOI：
10.1258/1357633011936435
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发表时间：
2001-01-01
影响因子：
4.7
通讯作者：
Viikinkoski, P
中科院分区：
文献类型：
--
作者：
Harno, K;Arajärvi, E;Viikinkoski, P
在一项为期八个月的前瞻性比较研究中，研究了视频会议在骨科初级和二级护理之间的临床效果和成本。对芬兰两家地区医院的普外科门诊进行了比较：佩哈斯医院(Peijas Hospital)有远程医疗，Hyvinkaa医院没有远程医疗。这三个研究初级保健中心总共将419名成年患者转介到门诊诊所。根据居住在Hyvinkaa医院市镇的老年人比例进行调整后，Peijas医院转诊到Peijas医院的人口数量与Hyvinkaa医院的转诊数量相似。在Peijas医院转诊的225名患者中，168名(75%)在外科门诊预约，其余转诊患者接受远程会诊。所有转诊到Hyvinkaa医院的患者都在门诊预约。门诊就诊的直接成本比远程会诊高45%，每一次新的远程会诊的边际成本降低48欧元。对替代干预措施进行的费用最小化分析显示，远程会诊的净收益为2500欧元。在骨科一级和二级护理之间使用视频会议是适度的，尽管这种远程医疗方法的使用被证明减少了直接成本并具有成本效益。
The clinical effectiveness and costs of videoconferencing in orthopaedics between primary and secondary care were examined in an eight-month prospective, comparative study. The general surgery outpatient clinics of two Finnish district hospitals were compared: Peijas Hospital, with telemedicine, and Hyvinkaa Hospital, without it. The three study primary-care centres referred a total of 419 adult patients to the outpatient clinics. The population-based number of referrals to Peijas Hospital was similar to that to Hyvinkaa Hospital after adjusting for the proportion of older people living in the Hyvinkaa Hospital municipalities. Of the 225 patients referred to Peijas Hospital, 168 (75%) were given appointments at the outpatient clinic of surgery and the rest of the referred patients received a teleconsultation. All patients referred to Hyvinkaa Hospital were given appointments at the outpatient clinic. The direct costs of an outpatient visit were 45% greater per patient than for a teleconsultation, with a marginal cost decrease of EU48 for every new teleconsultation. A cost-minimization analysis of the alternative interventions showed a net benefit of EU2500 in favour of teleconsultations. The use of videoconferencing between primary and secondary care was modest in orthopaedics, although the use of this telemedicine method was shown to reduce direct costs and be cost-effective.