基层医疗机构的电子就诊和随后的医疗接触:一项基于登记的研究

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Hanna Glock, Ulf Jakobsson, Beata Borgström Bolmsjö, Veronica Milos Nymberg, Moa Wolff, Susanna Calling
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引用次数: 0

摘要

与虚拟就诊相关的医疗保健使用证据并不一致。人们呼吁对基于文本的虚拟就诊(eVisits)的有效性进行更多研究。因此,我们调查了初级医疗电子就诊后的患者特征、诊断和后续医疗接触。我们对瑞典一家全虚拟公共初级医疗单位的电子就诊和 14 天内的后续医疗接触进行了一项基于登记的队列研究。2021 年的数据来自地区医疗数据库。诊断结果按相关诊断组进行分类,如皮肤诊断和呼吸道诊断。以后续医疗接触作为结果变量,以电子就诊的诊断组别作为预测变量,进行了多元逻辑回归。分析根据年龄、性别和社会经济指数进行了调整。共有 5817 人次接受了护士的电子就诊,4267 人次接受了全科医生的电子就诊(N = 10 084)。大多数患者年龄在 20 至 39 岁之间(41.8%)。皮肤诊断最为常见(47.3%),其次是呼吸道诊断(19.9%)。在与护士或全科医生完成电子就诊的患者中,约有四分之一(25.8%)的患者在 14 天内进行了后续的面对面就诊,其中大部分是初级保健。与全科医生相比,护士电子问诊后的后续联系更为频繁。与其他各种诊断的患者相比,电子就诊全科医生后,感染(尤其是呼吸道感染,也包括泌尿道感染)和不明诊断(尤其是与皮肤相关的诊断)的患者更有可能需要进一步接触医疗保健服务。然而,电子就诊在替代实体就诊方面的有效性,以及在满足初级保健人群更复杂的保健需求方面的资源利用率,都有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
eVisits to primary care and subsequent health care contacts: a register-based study
Evidence concerning health care use related to virtual visits is conflicting. More research has been called for regarding the effectiveness of text-based virtual visits (eVisits). Therefore, we investigated patient characteristics, diagnoses, and subsequent health care contacts after eVisits to primary care. We conducted a register-based cohort study of eVisits to an all-virtual public primary care unit in Sweden and subsequent health care contacts within 14 days. Data for 2021 were acquired from the regional health care databases. Diagnoses were sorted into relevant diagnostic groups, such as skin diagnoses and respiratory tract diagnoses. Multiple logistic regression was performed with subsequent health care contact as the outcome variable and diagnostic group for the eVisit as the predictor variable. Analyses were adjusted for age, sex, and socioeconomic index. There were 5817 eVisits to a nurse and 4267 eVisits to a general practitioner (N = 10 084). Most patients were 20 to 39 years of age (41.8%). Skin diagnoses were most frequent (47.3%), followed by respiratory tract diagnoses (19.9%). Approximately one-fourth (25.8%) of the patients who completed an eVisit with a nurse or a general practitioner had a subsequent face-to-face visit within 14 days, mostly in primary care. Subsequent contacts were more frequent after an eVisit to a nurse than to a general practitioner. After an eVisit to a general practitioner, patients with infections (especially respiratory tract but also urinary tract) and unspecified diagnoses (especially skin-related) were more likely to require further health care contact compared to a group with various other diagnoses. eVisits to an all-virtual primary care unit may be appropriate for uncomplicated medical complaints. Nonetheless, the effectiveness of eVisits in terms of substitution of physical visits, and resource utilization in relation to the more complex care needs of a primary care population, should be further studied.
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来源期刊
BMC Family Practice
BMC Family Practice 医学-医学:内科
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
4-8 weeks
期刊介绍: BMC Family Practice is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research. The journal has a special focus on clinical decision making and management, continuing professional education, service utilization, needs and demand, and the organization and delivery of primary care and care in the community.
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