A pilot study of telemedicine for post-operative urological care in children
A pilot study of telemedicine for post-operative urological care in children
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DOI：
10.1177/1357633x14555610
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发表时间：
2014-12-01
影响因子：
4.7
通讯作者：
Hurtt, Robbie
中科院分区：
文献类型：
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作者：
Canon, Stephen;Shera, Annashia;Hurtt, Robbie
我们对12个月内的小儿泌尿外科手术患者进行了回顾性研究。我们比较了通过远程医疗随访的患者和在小石城的阿肯色州儿童医院（ACH）现场进行术后随访的患者。居住在阿肯色州西北部的所有术前患者都有机会使用距离医院328公里的洛厄尔卫星诊所的远程医疗。在61名患者中，10名选择远程医疗，51名选择在ACH诊所接受评估。所有远程医疗访视均成功完成，但在4例病例中，远程医疗图像的视频清晰度不足以做出决策，并通过电子邮件向ACH的医生发送了数字照片。两组患者均无术后手术并发症。在远程医疗组中，到ACH的中位距离为330 km，到远程诊所的中位距离为35 km。在现场组中，到ACH的中位距离为293 km，显著更短（P=0.03）。在现场组中，至ACH的中位行程时间为174分钟。如果远程医疗组开车去医院，中位旅行时间将是192分钟。Logistic回归显示，与ACH的距离每增加37 km，与接受现场护理相比，患者接受远程医疗的几率增加111%（OR=2.1，95% CI：1.0，4.4）。试点研究支持使用远程医疗对儿科泌尿外科手术患者进行术后评估，并表明可以节省大量的旅行距离和时间。
We conducted a retrospective study of paediatric urological surgery patients over a 12-month period. We compared patients followed up by telemedicine with those who had post-operative follow-up on site at the Arkansas Children's Hospital (ACH) in Little Rock. All pre-operative patients living in northwest Arkansas were given the opportunity to use telemedicine from a satellite clinic at Lowell, 328km from the hospital. Of 61 patients, 10 chose telemedicine and 51 chose to be evaluated at the ACH clinic. All telemedicine visits were completed successfully, but in four cases, the video clarity of the telemedicine images was not sufficient for decision-making, and a digital photograph was sent by email to the physician at the ACH. There were no post-operative surgical complications in either patient group. In the telemedicine group, the median distance to the ACH was 330km, and the median distance to the remote clinic was 35km. In the on-site group, the median distance to the ACH was 293km, which was significantly less (P=0.03). In the on-site group, the median travel time to the ACH was 174min. If the telemedicine group had driven to the hospital, the median travel time would have been 192min. Logistic regression showed that for every 37km increase in distance to ACH, patients had a 111% increase in the odds of receiving telemedicine compared to receiving on-site care (OR=2.1, 95% CI: 1.0, 4.4). The pilot study supports the use of telemedicine for the post-operative evaluation of paediatric urology surgery patients and suggests that substantial travel distance and time savings can be made.