Effectiveness of Telemedicine in Surin Fast Track Referral System
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Abstract
Background: The referral system is a crucial component of emergency care system. However, the specialized personnel in each area are limited, which may result in inadequate care, particularly fast track patients who require complex care. Implementing telemedicine in transfer process can enhance the quality of care.
Objective: To study the effectiveness of the telemedicine system between Surin hospital and district hospitals in ensuring appropriate care for fast track patients before and during transfer, changes in disease severity, 24-hour and 30-day mortality rate post-transfer.
Methods: This research is a quasi-experimental study. The sample consists of fast track patients who were transferred from district hospitals to Surin hospital between August 10th and November 21st, 2023. Data were collected before and after implementation. The collected data were analyzed using Student's t-test, Wilcoxon rank-sum test, Pearson's Chi-squared test, Fisher's exact test and Relative risk (95% CI).
Results: Out of 1,022 patients, 495 were from pre-implementation phase of telemedicine and 527 were from post-implementation phase. In post-implementation phase, the appropriateness of care was significantly higher (93.7% vs 78.6%, RR 1.19, 95% CI 1.13-1.25, p-value < 0.001) and median Modified Early Warning Score decrease after transfer was greater (2 vs 0, p-value < 0.001). There was no significant difference in 24-hour and 30-day mortality rates (p-value 0.268, 0.465).
Conclusion: The use of a telemedicine in care of fast track referral patients enhances the appropriateness of care and reduce the severity of diseases.
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