A Novel Emergency Department-Based Telemedicine Program: How Do Older Patients Fare?
Telemed J E Health
; 25(10): 966-972, 2019 10.
Article
en En
| MEDLINE
| ID: mdl-30358524
Introduction:When we started using telemedicine to treat low acuity patients in the emergency department (ED), we assumed that this voluntary treatment pathway would primarily be used by younger patients. We were surprised to find that a significant portion of patients evaluated by telemedicine were older adults.Materials and Methods:We conducted a retrospective cohort study of quality assurance data. Adult ED patients at an urban academic medical center who had their care provided by telemedicine from July 2016 to September 2017 were included. We measured demographic characteristics, ED length of stay (LOS), triage severity score, X-ray orders placed, ED revisit within 72 h, need for change in treatment plan or admission on 72-h return, and patient satisfaction.Results:Of 1,592 patients evaluated, 18% were age 65 and older. Older patients were more likely to be evaluated for wound care and less likely to be evaluated for nontraumatic connective tissue illnesses. Older patients also had shorter median LOS (59 min vs. 63 min). Unplanned 72-h return (2% vs. 2%), likelihood to have a change in treatment on return (1% vs. 0.2%), and patient satisfaction were similar between age groups. The percentage of patients who returned in 72 h requiring admission were similar between age groups (0.4% vs. 0.1% p = 0.325). Sensitivity analysis with an age threshold at 75 years did not change primary results.Conclusion:These findings suggest that among low acuity patients there are groups of older adults for whom an ED telemedicine evaluation can provide safe and effective medical care that is satisfactory to patients.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Telemedicina
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Servicio de Urgencia en Hospital
Tipo de estudio:
Observational_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Telemed J E Health
Asunto de la revista:
INFORMATICA MEDICA
/
SERVICOS DE SAUDE
Año:
2019
Tipo del documento:
Article
Pais de publicación:
Estados Unidos