%0期刊文章%@ 1438-8871 %I JMIR出版物%V 23%卡塔尔世界杯8强波胆分析 N 11% P e30632 %T远程医疗在农村和偏远急诊部门的有效性:系统综述A Tsou,Christina,A Robinson,Suzanne,A Boyd,James,A Jamieson,Andrew,A Blakeman,Robert,A Yeung,Justin,A McDonnell,Josephine,A Waters,Stephanie,A boich,Kylie,A Hendrie,Delia +科廷大学人口健康学院，宾利，6102，澳大利亚，61 08 92669266，christina.tsou@curtin.edu.au %K远程保健%K远程医疗%K临床效果%K治疗结果%K农村人口%K农村保健%K远程%D 2021 %7 26.11.2021 %9回顾%J J医学互联网Res %G英文%X背景:紧急远程保健已被用于改善居住在农村和偏远地区的患者获得专科护理的机会，希望减轻他们所经历的重大健康差距。农村和偏远地区急诊科的病人处置决定可能很复杂，在很大程度上取决于当地(接收端)医院的专业知识和经验。虽然在农村和偏远急诊科的临床实践中，对于非急性症状的急诊远程医疗的有效性已经有了一些综合证据，但对诸如临床区域和症状敏锐度等背景因素对这些发现的影响的评估有限。目的:本系统综述的目的是检查用于研究农村和远程急诊科远程医疗有效性的结局指标，并分析这些结局指标被使用和解释的临床背景。方法:搜索策略使用医学主题标题和等价的主题描述符列表来查找涵盖4个关键领域的文章:远程健康或远程医疗、急诊、有效性和农村和远程。研究采用人口、干预、比较器、感兴趣的结果和研究设计框架进行选择。在1990年1月1日至2020年5月23日的搜索期间，该搜索策略应用于MEDLINE (Ovid)、Cochrane图书馆、Scopus、CINAHL、ProQuest和EconLit，以及评论和传播中心数据库(例如，国家卫生服务经济评估数据库)。对纳入研究中使用的结果测量进行了定性综合，特别是在其解释的临床背景下。 Results: A total of 21 full-text articles were included for qualitative analysis. Telehealth use in rural and remote EDs demonstrated effectiveness in achieving improved or equivalent clinical effectiveness, appropriate care processes, and—depending on the context—improvement in speed of care, as well as favorable service use patterns. The definition of effectiveness varied across the clinical areas and contexts of the studies, and different measures have been used to affirm the safety and clinical effectiveness of telehealth in rural and remote EDs. The acuity of patient presentation emerged as a dominant consideration in the interpretation of interlinking time-sensitive clinical effectiveness and patient disposition measures such as transfer and discharge rates, local hospital admission, length of stay, and ED length of stay. These, together with clinical area and acuity of presentation, are the outcome determination criteria that emerged from this review. Conclusions: Emergency telehealth studies typically use multiple outcome measures to determine the effectiveness of the services. The outcome determination criteria that emerged from this analysis are useful when defining the favorable direction for each outcome measure of interest. The findings of this review have implications for emergency telehealth service design and policies. Trial Registration: PROSPERO CRD42019145903; https://tinyurl.com/ndmkr8ry %M 34842537 %R 10.2196/30632 %U //www.mybigtv.com/2021/11/e30632 %U https://doi.org/10.2196/30632 %U http://www.ncbi.nlm.nih.gov/pubmed/34842537