第四代远程医疗项目合同履约率对慢性肾病患者住院风险的影响卡塔尔世界杯8强波胆分析回顾性队列研究%洪阿，李志胜，李振光，陈英贤，黄英贤，吴静昌，吴文仙，吴慧雯，张慧雯，何宝玉，何义伦%+台湾台北市中山南路7号国立台湾大学医院远程医疗中心，886 2 2312 3456,ylho@ntu.edu.tw %K远程医疗%K合同遵守率%K慢性肾脏疾病%D 2018 %7 24.01.2018 %9原始论文%J J医学互联网研究%G英文%X慢性肾脏疾病(CKD)在台湾普遍存在，且与高全因死亡率相关。我们在之前的一篇论文中表明，与常规护理相比，第四代远程医疗项目的全因死亡率较低，风险比为0.866 (95% CI 0.837-0.896)。目的:本研究旨在评估肾功能状况对接受该方案患者住院的影响，并评估CKD患者合同遵守率与住院风险的关系。方法:对715例接受远程医疗的患者进行回顾性分析。合同履约率的定义是住院前远程保健服务覆盖的天数百分比。患者根据肾功能状况分为三组:(1)肾功能正常，(2)CKD，或(3)终末期肾病(ESRD)和维持透析。结果测量首先是心血管和全因住院。采用含时间相关协变量的Cox比例风险模型分析合同履约率、肾功能状况和住院风险之间的关系。 Results: The median follow-up duration was 694 days (IQR 338-1163). Contract compliance rate had a triphasic relationship with cardiovascular and all-cause hospitalizations. Patients with low or very high contract compliance rates were associated with a higher risk of hospitalization. Patients with CKD or ESRD were also associated with a higher risk of hospitalization. Moreover, we observed a significant interaction between the effects of renal function status and contract compliance rate on the risk of hospitalization: patients with ESRD, who were on dialysis, had an increased risk of hospitalization at a lower contract compliance rate, compared with patients with normal renal function or CKD. Conclusions: Our study showed that there was a triphasic relationship between contract compliance rate to the telehealth program and risk of hospitalization. Renal function status was associated with risk of hospitalization among these patients, and there was a significant interaction with contract compliance rate. %M 29367185 %R 10.2196/jmir.8914 %U //www.mybigtv.com/2018/1/e23/ %U https://doi.org/10.2196/jmir.8914 %U http://www.ncbi.nlm.nih.gov/pubmed/29367185