@Article{信息:doi 10.2196 / / jmir。6783，作者=“Gordon, Aliza S和Adamson, Wallace C和DeVries, Andrea R”，标题=“急性，非紧急护理的虚拟访问:事件级使用的索赔分析”，期刊=“J Med Internet Res”，年=“2017”，月=“2”，日=“17”，卷=“19”，数=“2”，页=“e35”，关键词=“虚拟访问;保健利用;背景:随着移动设备的使用和患者对即时、方便获得医疗服务的需求的增长，虚拟医疗保健(通过互联网与医生进行实时视频咨询)的扩展将继续下去。目的:本研究的目的是分析3周内虚拟就诊所提供的护理和费用，并将其与亲自前往零售健康诊所(RHC)、紧急护理中心(UCC)、急诊科(ED)或初级保健医生(PCP)就诊的急性、非紧急情况进行比较。方法:对一家大型商业健康保险公司的索赔进行横断、回顾性分析，以比较通过虚拟访问接受治疗的患者(鼻窦炎、上呼吸道感染、尿路感染、结膜炎、支气管炎、咽炎、流感、咳嗽、皮炎、消化症状或耳痛)与在其他环境中接受治疗的类似疾病的患者的护理和费用。一次发作定义为第一次就诊加上之后的3周。患者为年龄小于65岁的儿童和成人，无严重慢性疾病。根据访问发生的环境对访问进行了分类。通过门诊随访、急诊就诊或住院治疗评估所提供的护理; laboratory tests or imaging performed; and antibiotic use after the initial visit. Episode costs included the cost of the initial visit, subsequent medical care, and pharmacy. Results: A total of 59,945 visits were included in the analysis (4635 virtual visits and 55,310 nonvirtual visits). Virtual visit episodes had similar follow-up outpatient visit rates (28.09{\%}) as PCP (28.10{\%}, P=.99) and RHC visits (28.59{\%}, P=.51). During the episode, lab rates for virtual visits (12.56{\%}) were lower than in-person locations (RHC: 36.79{\%}, P<.001; UCC: 39.01{\%}, P<.001; ED: 53.15{\%}, P<.001; PCP: 37.40{\%}, P<.001), and imaging rates for virtual visits (6.62{\%}) were typically lower than in-person locations (RHC: 5.97{\%}, P=.11; UCC: 8.77{\%}, P<.001; ED: 43.06{\%}, P<.001; PCP: 11.26{\%}, P<.001). RHC, UCC, ED, and PCP were estimated to be {\$}36, {\$}153, {\$}1735, and {\$}162 more expensive than virtual visit episodes, respectively, including medical and pharmacy costs. Conclusions: Virtual care appears to be a low-cost alternative to care administered in other settings with lower testing rates. The similar follow-up rate suggests adequate clinical resolution and that patients are not using virtual visits as a first step before seeking in-person care. ", issn="1438-8871", doi="10.2196/jmir.6783", url="//www.mybigtv.com/2017/2/e35/", url="https://doi.org/10.2196/jmir.6783", url="http://www.ncbi.nlm.nih.gov/pubmed/28213342" }