延续医学手机软件在新型冠状病毒肺炎疫情期间的应用

The Adhibition of Transitional Care Mobile Application during Corona Virus Diseases 2019 Epidemic

目的:利用自主开发的延续医学手机软件,优化神经内科出院患者新型冠状病毒肺炎(COVID-19)疫情期间院外管理,进一步探索资源优化的互联网+医疗模式。方法:回顾性分析COVID-19疫情期间(2020年1月1日~2020年6月18日)与2019年同期延续医学手机软件的使用情况,比较患者的新增注册量、年龄与疾病构成、相关信息上传数量与构成情况,以及使用该软件的缺血型脑卒中患者疫情期间复发再住院率,分析延续医学手机软件服务模式的作用及疫情对神经内科诊疗行为的影响。结果:COVID-19疫情期间新增注册患者67人,其中脑卒中患者49人(73.13%);2019年同期新增注册患者224人,其中脑卒中患者123人(54.91%)。疫情期间脑卒中患者的注册比例较2019年同期有所增加(P=0.01)。疫情期间新增注册患者上传体征类信息950条,人均14.18条;2019年同期患者上传信息1916条,人均8.55条。人均体征信息上传量同比增长65.85%。疫情期间咨询类信息上传253条,人均3.78条;2019年同期为1138条,人均5.08条,人均咨询信息上传量同比减少了25.60%。2017~2019年缺血型脑卒中患者共1703人,疫情期间17人复发再次住院,总复发再住院率为1.00%。其中,注册使用延续医学手机软件的有3人,复发再住院率0.58%;未注册使用延续医学手机软件的14人,复发再住院率1.18%。两组复发再住院率差异无统计学意义(P>0.05)。结论:COVID-19疫情期间,神经内科延续医学手机软件为脑卒中等神经内科疾病出院患者提供了一种便捷的病情随访、用药及护理咨询服务,为构建资源优化的互联网医疗模式做出了进一步探索。

Objective:To optimize out-of-hospital management of neurology patients during Corona Virus Diseases 2019(COVID-19)epidemic by using self-developed Transitional Care mobile application.Methods:Retrospective case-control study.The usages of Transitional Care mobile application were compared COVID-19 epidemic(on January 1,2020 to June 18,2020)and the same period in 2019.The number of new registrations,age and disease composition,the number and composition of information uploaded,and recurrence and readmission rate of ischemic stroke patients during COVID-19 epidemic were compared.Furthermore,the effect of Transitional Care Internet medical model and impact of COVID-19 epidemic on diagnosis and treatment behavior in neurology department were analyzed.Results:During the COVID-19 epidemic,there were 67 freshly registered patients with an average age of 62.01±14.89 years old,including 49 stroke patients(accounting for 73.13%).In the same period of 2019,there were 224 newly registered patients with an average age of 61.34±16.73 years old,including 123 stroke patients(accounting for 54.91%).The registered proportion of stroke patients during COVID-19 increased compared with the same period of 2019(P=0.01).950 pieces of sign information were uploaded by newly registered patients during the COVID-19 epidemic(14.18 pieces per person).In the same period of 2019,the number was 1,916(8.55pieces per person),with a year-on-year increase of 65.85%in the number of sign information uploads per person.253 pieces of consultative information were uploaded during the COVID-19 epidemic(3.78 pieces per person).In the same period of 2019,the number was 1,138(5.08 per person),and the number of consultative information uploads per person decreased by25.60%.A total of 1703 ischemic stroke patients were included and observed from 2017 to 2019.During the COVID-19 epidemic,a total of 17 patients relapsed and were readmitted to the hospital,with a total recurrence and readmission rate of 1.00%.Among them,three patients within the group registered to use the mobile software of continuing medicine had a recurrence and readmission rate of0.58%.Otherwise,there were 14 patients within the group who were not registered to use the Transitional Care mobile application,and the recurrence and readmission rate was 1.18%.However,there was no significant statistical difference in the recurrence and readmission rate between the two groups during the COVID-19 epidemic(P>0.05).Conclusion:Transitional Care mobile application provided convenient consultation services,including follow-up,medication and nursing during COVID-19 epidemic.Further exploration has been made on the construction of resource optimization Internet medical mode.