遠距照護於心血管疾病應用之初探

The Application of Telehealth Care for Patients with Cardiovascular Diseases

了解遠距照護對心血管疾病患者的疾病控制及醫療耗費之影響。自2009/11/16 至2010/6/30 為止，針對心血管疾病患者，提供生理監測儀器居家量測，結合遠距照護資訊網路，建構出院病友之遠距照護中心平台，使病友出院返家後可獲得個案管理師的健康諮詢與持續照護。總個案數為119 位（73 位男性，46 位女性，平均年齡68±15 歲），接受遠距照護後平均血壓從90.7± 4.3 mmHg 下降至87.1±6.1 mmHg （p=.047），飯前血糖自143.9± 34.8 mg/dL 減少為131.6± 40.6 mg/dL （p=.02），每個月平均住院天數由1.71±3.31 日／人下降為0.95± 3.18 日／人 （p=.04），健保支出也自每月24,773 元減少到14,907 元 （p=.003）。顯示接受遠距照護後心血管的高危險因子如血壓、血糖均能獲得良好控制，也能有效減少住院日數及健保支出。

Integrated personal health records are combined with home monitoring and hospital electronic charts. Based on the integrated personal health records, case managers can seek opinions from the medical team and provide feedbacks. The present study was to evaluate the cost-effectiveness of telehealth care for patients with cardiovascular diseases. In 2009, NTUH has also built up the telehealth care center and started the innovative remote care system for cardiovascular diseases. A total of 119 patients (73 males, 46 females; mean age, 68 ± 15 years) were enrolled. The mean blood pressure was reduced from 90.7± 4.3 mmHg to 87.1±6.1 mmHg (p=.047). The fasting blood glucose was reduced from 143.9± 34.8 mg/dL to 131.6± 40.6 mg/dL (p=.02). The mean duration of hospital stay was reduced from 1.71± 3.31 to 0.95± 3.18 day per person per month (p=.04). The total medical expense were reduced from NT$24,773 to NTU$4,907 (p=.003). The telehealth care system can help cardiovascular patient to control blood pressure and sugar. It significantly decreased length of hospital stay and saving medical expense.