Teleconsultation as a replacement for referral to an outpatient clinic
Teleconsultation as a replacement for referral to an outpatient clinic
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DOI：
10.1258/1357633021937550
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发表时间：
2002-01-01
影响因子：
4.7
通讯作者：
Köymäri-Seilonen, T
中科院分区：
文献类型：
--
作者：
Jaatinen, PT;Aarnio, P;Köymäri-Seilonen, T
我们对芬兰一家初级保健中心的转诊患者进行了一项随机病例对照研究。包括Pori的萨塔昆塔中心医院的内科医生和外科医生以及Harjavalta的Satalinna医院的老年病医生在五个月内处理的七名全科医生的所有咨询和转诊。对于对照组患者，将常规转诊信发送到医院门诊。对于干预组的患者，全科医生必须决定他们是否希望与医院进行电子咨询或希望转诊患者（即转移治疗责任）。然后通过一个安全的基于网络的系统与医院专家进行通信。93例患者同意参加研究。没有人拒绝，但有15人没有参加。满意度数据来自患者和医生完成的问卷调查。所有接受远程会诊的患者都表示他们希望将来进行同样的手术，63%的对照组表示他们下次更愿意接受远程会诊。医生们很快就学会了成功地利用远程医疗模式。在52%采用远程咨询的病例中，治疗责任仍由保健中心承担，无需前往医院就诊。全科医生和医院医生同意后续治疗。远程转诊增加了全科医生承担治疗责任的可能性。远程医疗模式减少了医院就诊次数，应可节省大量费用。
We conducted a randomized case control study of referrals from a primary care centre in Finland. All the consultations and referrals from seven general practitioners (GPs) dealt with by internists and surgeons at Satakunta Central Hospital in Pori and geriatricians at Satalinna Hospital in Harjavalta over five months were included. For patients in the control group, a conventional referral letter was sent to the hospital outpatient clinic. For patients in the intervention group, the GPs had to decide whether they wanted an electronic consultation with the hospital or wanted to refer the patient (i.e. to transfer responsibility for treatment). Communication with the hospital specialist was then via a secure Web-based system. Ninety-three patients consented to participate in the study. None refused, although there were 15 non-attenders. Satisfaction data were collected from questionnaires completed by the patients and doctors. All the patients treated by tele-consultation said that they wanted the same procedure in future and 63% of the control group said they would prefer a teleconsultation next time. The doctors quickly learned to exploit the telemedicine model successfully. The responsibility for treatment was maintained in the health centre in 52% of cases using teleconsultation, without any visit to hospital being required. The Gps and the hospital doctors agreed on the follow-up treatment. Telereferral increased the possibility of the GP maintaining responsibility for the treatment. The reduced number of hospital visits in the telemedicine model should produce significant cost savings.