1 Silver Chain Group , Perth, Western Australia, Australia .
Telemed J E Health. 2013 Sep;19(9):652-7. doi: 10.1089/tmj.2012.0244. Epub 2013 Jun 28.
To determine if self-monitoring via home-based telehealth equipment could, when combined with ongoing remote monitoring by a nurse, reduce the incidence of hospitalizations and emergency department (ED) presentations for people with chronic obstructive pulmonary disease (COPD).
A randomized controlled trial was used to compare the outcomes for participants receiving the telehealth equipment and monitoring with those for participants in an information-only control group, over a period of 6 months. Participants receiving the telehealth intervention were taught to measure and record their vital signs (blood pressure, weight, temperature, pulse, and oxygen saturation levels) on a daily basis. These were then transmitted automatically via telephone to a secure Web site where they were monitored each day by the telehealth nurse.
The telehealth group had fewer ED presentations and hospital admissions and a reduced length of stay in comparison with the control group. These results were not statistically significant. However, the reduction in health service use was large enough to result in significant cost savings, with the annual cost savings of the telehealth group compared with the control group being $2,931 per person.
Telehealth monitoring of patient vital signs reduced health service utilization for individuals with COPD and resulted in significant cost savings. In terms of individual health benefits, improvements in participants' self-management behaviors and control over their condition was evident.
确定通过家庭远程医疗设备进行自我监测,与护士持续进行远程监测相结合,是否可以降低慢性阻塞性肺疾病(COPD)患者的住院和急诊(ED)就诊率。
本研究采用随机对照试验,将参与者分为远程医疗设备和监测组与信息对照组,比较两组参与者在 6 个月内的结果。接受远程医疗干预的参与者被教导每天测量并记录自己的生命体征(血压、体重、体温、脉搏和血氧饱和度水平)。然后,这些数据通过电话自动传输到一个安全的网站,由远程医疗护士每天进行监测。
与对照组相比,远程医疗组的 ED 就诊次数和住院次数更少,住院时间也更短。但这些结果没有统计学意义。然而,医疗服务利用率的降低足以带来显著的成本节约,与对照组相比,远程医疗组的每人每年节省成本为 2931 美元。
对 COPD 患者的生命体征进行远程医疗监测可减少医疗服务的使用,并带来显著的成本节约。就个人健康收益而言,参与者自我管理行为的改善和对自身病情的控制得到了明显的体现。