Place of telemedicine in the organization of emergency care: feasibility and benefits.

IF 2.3 3区 医学 Q1 EMERGENCY MEDICINE
Houda Ben Soltane, Ines Lazrak, Souhir Chelly, Mariem Khrouf, Salma Younes, Ons Haddaji, Mohamed Mahjoub, Zied Mezgar
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引用次数: 0

Abstract

Introduction: Telemedicine encompasses all medical practices that allow patients to be remotely cared for through new information and communication technologies. This study aims to assess the remote management of patients consulting emergency services and not requiring in-hospital care during both pre-pandemic and pandemic periods of COVID-19.

Methods: This was a prospective, randomized, controlled study. The telemedicine group received follow-up at home after emergency room discharge according to a predefined protocol, with telephone calls on days 2, 7, 15, and 30. The control group received standard care without regular telephone follow-up (only a call on day 30). The study was conducted with patients consulting the emergency department of FarhatHached Hospital in Sousse. Patient inclusion occurred between November 1, 2019, and April 30, 2020. The primary outcome measures were the re-consultation rate and treatment adherence. The secondary outcome measure was patient satisfaction.SPSS version 23.0 for Windows was used for data analysis. Descriptive statistics calculated frequencies, percentages, means, standard deviations, medians, and range. Analytical study involved Student's t-test and Pearson chi-square test for mean and frequency comparisons, respectively. Significance threshold (p) for all tests was set at 0.05.

Results: A total of 400 patients were included. The average age of patients was 40 years. Both groups were comparable in terms of demographics and clinical characteristics. Diagnoses included mainly benign infectious diseases, trauma, mild decompensations of chronic conditions (asthma, COPD, heart failure), and suspected COVID cases. Patients in the telemedicine group tended to reconsult less in the month following their initial emergency room visit (14% versus 26.5%) (p = 0.004). There was a significant difference in treatment adherence between the telemedicine group and the control group (97.5% versus 92%; p = 0.014). The satisfaction with telemedicine was higher than satisfaction with regard to an in-person consultation at the emergency department (90% versus 37.5%).

Conclusion: It is necessary to implement telemedicine in Tunisia, especially in emergency services. It ensures better remote patient care by reducing re-consultation rates, increasing treatment adherence, and improving patient satisfaction.

远程医疗在急救组织中的地位:可行性和益处。
导言:远程医疗包括通过新的信息和通信技术对患者进行远程护理的所有医疗行为。本研究旨在评估 COVID-19 大流行前和大流行期间对急诊病人的远程管理情况:这是一项前瞻性、随机对照研究。远程医疗组在急诊室出院后按照预定方案在家接受随访,第 2、7、15 和 30 天进行电话随访。对照组接受标准护理,没有定期电话随访(仅在第 30 天进行电话随访)。研究对象为在苏塞 FarhatHached 医院急诊科就诊的患者。患者纳入时间为 2019 年 11 月 1 日至 2020 年 4 月 30 日。主要结果指标是再次就诊率和治疗依从性。数据分析采用 SPSS 23.0 Windows 版本。描述性统计计算了频率、百分比、平均值、标准差、中位数和范围。分析研究分别采用学生 t 检验和皮尔逊卡方检验进行平均值和频率比较。所有检验的显著性临界值(p)均定为 0.05:结果:共纳入 400 名患者。患者的平均年龄为 40 岁。两组患者在人口统计学和临床特征方面具有可比性。诊断主要包括良性传染病、外伤、慢性病(哮喘、慢性阻塞性肺病、心力衰竭)轻度失代偿以及疑似 COVID 病例。远程医疗组患者在首次急诊就诊后的一个月内复诊率较低(14% 对 26.5%)(p = 0.004)。远程医疗组与对照组在治疗依从性方面存在明显差异(97.5% 对 92%;p = 0.014)。对远程医疗的满意度高于对急诊科现场咨询的满意度(90% 对 37.5%):突尼斯有必要实施远程医疗,尤其是在急诊服务中。结论:有必要在突尼斯实施远程医疗,尤其是在急诊服务中,它可以通过降低再次就诊率、提高治疗依从性和改善患者满意度,确保更好地远程患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Emergency Medicine
BMC Emergency Medicine Medicine-Emergency Medicine
CiteScore
3.50
自引率
8.00%
发文量
178
审稿时长
29 weeks
期刊介绍: BMC Emergency Medicine is an open access, peer-reviewed journal that considers articles on all urgent and emergency aspects of medicine, in both practice and basic research. In addition, the journal covers aspects of disaster medicine and medicine in special locations, such as conflict areas and military medicine, together with articles concerning healthcare services in the emergency departments.
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