Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System
Electronic Consults in Otolaryngology: A Pilot Study to Evaluate the Use, Content, and Outcomes in an Academic Health System
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DOI：
10.1177/0003489419882726
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发表时间：
2019-10-18
影响因子：
1.4
通讯作者：
Friedman, Lawrence
中科院分区：
文献类型：
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作者：
Gilani, Sapideh;Bommakanti, Krishna;Friedman, Lawrence
目的：对初级保健医生(PCP)的耳鼻喉科电子会诊(EConsults)的主要原因进行分类。以确定有多少患者避免了随后亲自前往耳鼻喉科办公室就诊。方法：这是对2016至2017年间加州大学圣地亚哥分校(UCSD)医学中心初级保健医生进行的一项关于成人耳鼻喉科电子咨询的试点研究的回顾分析。这些投诉被归类为与以下方面有关的：耳朵、鼻子、喉咙或脖子。最初的建议被归类为(1)仅提供教育(不干预)，(2)建议由初级保健医生提供药物治疗，或(3)建议手术干预。采用单变量统计和多项Logistic回归分析问题类型与耳鼻咽喉科随访需求之间的关系。对数据进行了分析，以确定患者年龄和性别的差异。结果：研究人群包括患者(平均年龄54.6岁，男性60.9%)。在这一群体中，41%的咨询是关于耳朵的投诉，15%的咨询是关于鼻子的投诉，28%的咨询是关于喉咙的投诉，16%的咨询是关于颈部的投诉。82.8%的咨询者不需要面对面的随访。总体而言，76.9%的耳朵、100%的鼻子、88.9%的喉咙和70.0%的颈部疾病不需要亲自就诊。结论：耳鼻咽喉科的电子会诊主要针对耳部问题。在电子咨询中，82.4%的人不需要面对面的跟进。因此，我们得出结论，电子咨询的使用阻止了原本不必要的大量办公室访问。应努力促进电子咨询的广泛使用，这可能有助于更有效地利用资源。
Objectives: To categorize the primary reasons for electronic consults (eConsults) to otolaryngology from primary care physicians (PCPs). To determine how many patients avoided subsequent in-person otolaryngology office visits. Methods: This is a retrospective analysis of a pilot study that took place between 2016 and 2017 regarding eConsults to adult otolaryngology placed by primary care physicians at the University of California, San Diego (UCSD) Medical Center. The complaints were categorized as related to the following: ear, nose, throat or neck. Initial recommendations were classified as (1) providing education only (no intervention), (2) suggesting medical therapy provided by the PCP, or (3) suggesting surgical intervention. Univariate statistics and multinomial logistic regression were used to analyze the association of problem type with the need for follow-up in the otolaryngology offices. The data was analyzed for differences in patient age and gender. Results: The study population included 64 patients (average age 54.6 years, 60.9% male). Within this group, 41% of consults were for ear complaints, 15% for nose complaints, 28% had throat-related complaints, and 16% had neck-related complaints. In-person follow-up was not required for 82.8% of the consults. Overall, 76.9% of ear, 100% of nose, 88.9% of throat, and 70.0% of neck complaints did not require in-person visits. Conclusions: eConsults to otolaryngology were primarily for ear concerns. Of the eConsults, 82.4% did not require in-person follow-up. We therefore conclude that the use of eConsults prevented substantial office visits that would not otherwise be necessary. Efforts should be made to promote the widespread use of eConsults, which may to the more efficient use of resources.