Statens beredning för medicinsk och social utvärdering
Neonatal telehemsjukvård
När ett barn föds för tidigt eller är sjukt efter förlossningen kan anknytningen mellan barn och föräldrar påverkas negativt. Personalen kan av föräldrar uppfattas som ett hinder för egen kontakt med barnet och sjukhuslokalernas förutsättningar kan göra att tiden familjen spenderar tillsammans är begränsad. Neonatal hemsjukvård innebär att barnet vårdas i hemmet men är fortsatt inskrivet på neonatal vårdavdelning, där rondning och annan kontroll av barnets hälsa sker vid hembesök. Detta istället för att ligga kvar på sjukhuset.
Telemedicin är ett vitt begrepp som innebär medicinsk vård på distans. Det kan ske via till exempel telefonsamtal eller videolänk och kan vara både mellan vårdpersonal och mellan vårdpersonal och patient. I det här svaret tar vi upp neonatal telehemsjukvård, en variant av den neonatala hemsjukvården där föräldrarna istället kommunicerar med avdelningen direkt från sitt eget hem. Oftast sker den neonatala telehemsjukvården via videolänk, för att vårdpersonalen ska kunna bedöma barnets status. Ibland används en vanlig surfplatta, men det finns också exempel där man använt specialutrustning. En anledning att använda telehemsjukvård är att man tänker sig att vårdens knappa resurser kan användas mer effektivt än vid traditionell hemsjukvård.
Är du patient/anhörig? Har du frågor om egna eller anhörigas sjukdomar – kontakta din vårdgivare eller handläggare.
Fråga SBU:s upplysningstjänst
Vilka vetenskapliga, inklusive hälsoekonomiska, studier finns av neonatal telehemsjukvård?
Frågeställare: Verksamhetschef, Region Gävleborg
Sammanfattning SBU:s upplysningstjänst
På SBU:s upplysningstjänst identifierar och redovisar vi sammanställd forskning (systematiska översikter) eller identifierar vetenskapliga studier som svar på en avgränsad fråga. Vi bedömer risken för bias (överskattning eller underskattning av resultat) i systematiska översikter och presenterar författarnas slutsatser från systematiska översikter med låg eller måttlig risk för bias. I vetenskapliga primärstudier bedömer vi inte risken för bias och därför presenteras de bara som referenser. Vid behov bedömer vi kvalitet avseende ekonomiska aspekter och överförbarhet av resultat i hälsoekonomiska studier och presenterar författarnas slutsatser från de studier som bedöms ha tillräcklig kvalitet. I svaren väger vi inte samman resultaten eller bedömer graden av vetenskaplig tillförlitlighet.
SBU:s upplysningstjänst har efter litteratursökning och kvalitetsgranskning inte inkluderat någon systematisk översikt i svaret. Vi har dock identifierat tre relevanta systematiska översikter som undersökt neonatal telehemsjukvård och där vi har bedömt att risken för bias är hög. SBU:s upplysningstjänst har även identifierat åtta primärstudier.
Två hälsoekonomiska studier har identifierats. En av dessa bedömdes ha tillräcklig kvalitet avseende ekonomiska aspekter samt överförbarhet av studiens ekonomiska resultat och redovisas i detta svar. Om neonatal telehemsjukvård skulle visa sig vara kliniskt effektivt och säkert för barnet har det också förutsättningar att vara kostnadsbesparande.
Liknande rapporter
Litteratursökning
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ("Infant, Newborn"[Mesh]) OR "Premature Birth"[Mesh] | 594 549 |
| 2. | (preterm[tiab] OR newborn[tiab] OR neonat*[tiab] OR prematur*[tiab]) | 501 829 |
| 3. | 1 OR 2 | 859 454 |
| Intervention: | ||
| 4. | ("Telemedicine"[Mesh]) | 25 805 |
| 5. | remote[tiab] OR NTH[tiab] OR telemedicine[tiab] OR tele-care[tiab] OR tele-homecare[tiab] OR "tele care"[tiab] OR "tele home care"[tiab] OR telephone[tiab] OR video[tiab] OR smartphone[tiab] NOT medline[sb] | 39 948 |
| 6. | 4 OR 5 | 68 461 |
| Final | 3 AND 6 | 1 182 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | NICU[tiab] | 9 328 |
| Intervention: | ||
| 2. | ("Telemedicine"[Mesh]) | 26 121 |
| 3. | (remote[tiab] OR NTH[tiab] OR telemedicine[tiab] OR tele-care[tiab] OR tele-homecare[tiab] OR "tele care"[tiab] OR "tele home care"[tiab] OR telephone[tiab] OR video[tiab] OR smartphone[tiab] OR webcam[tiab] OR web-cam[tiab]) NOT medline[sb] | 40 355 |
| 4. | 2 OR 3 | 66 476 |
| Final | 1 AND 4 | 73 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ("Infant, Newborn"[Mesh]) OR "Premature Birth"[Mesh] | 596 875 |
| 2. | (preterm[tiab] OR newborn[tiab] OR neonat*[tiab] OR prematur*[tiab] OR NICU[tiab]) | 505 263 |
| 3. | 1 OR 2 | 863 586 |
| Intervention: | ||
| 4. | (webcam[tiab] OR web-cam[tiab]) | 317 |
| Final | 1 AND 4 | 6 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: | ||
| 1. | MeSH descriptor: [Infant, Newborn] explode all trees | 15243 |
| 2. | MeSH descriptor: [Premature Birth] explode all trees | 1155 |
| 3. | (preterm):ti,ab,kw OR (neonat*):ti,ab,kw OR (Newborn):ti,ab,kw OR (prematur*):ti,ab,kw (Word variations have been searched) | 49519 |
| 4. | 1 OR 2 OR 3 | |
| Intervention: | ||
| 5. | MeSH descriptor: [Telemedicine] explode all trees | 2174 |
| 6. | (remote):ti,ab,kw OR (telemedicine):ti,ab,kw OR (tele-care):ti,ab,kw OR ("tele care"):ti,ab,kw OR ("tele homecare"):ti,ab,kw (Word variations have been searched) | 7 696 |
| 7. | ("tele-homecare"):ti,ab,kw OR (video):ti,ab,kw OR (telephone):ti,ab,kw OR (smartphone):ti,ab,kw (Word variations have been searched) | 32949 |
| 8. | 5 OR 6 OR 7 | |
| Final | 4 AND 8 | 1250 CDSR/29 CENTRAL/1220 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | 'newborn'/exp OR 'child, newborn':ti,ab OR 'full term infant':ti,ab OR 'human neonate':ti,ab OR 'human newborn':ti,ab OR 'infant, newborn':ti,ab OR 'neonate':ti,ab OR 'neonatus':ti,ab OR 'newborn':ti,ab OR 'newborn baby':ti,ab OR 'newborn child':ti,ab OR 'newborn infant':ti,ab OR 'newly born baby':ti,ab OR 'newly born child':ti,ab OR 'newly born infant':ti,ab OR 'prematurity'/exp OR 'infant, extremely premature':ti,ab OR 'infant, premature':ti,ab OR 'infant, premature, diseases':ti,ab OR 'neonate, premature':ti,ab OR 'pre-mature infant':ti,ab OR 'pre-term baby':ti,ab OR 'pre-term child':ti,ab OR 'pre-term infant':ti,ab OR 'pre-term neonate':ti,ab OR 'pre-term newborn':ti,ab OR 'premature':ti,ab OR 'premature baby':ti,ab OR 'premature birth':ti,ab OR 'premature child':ti,ab OR 'premature childbirth':ti,ab OR 'premature infant':ti,ab OR 'premature neonate':ti,ab OR 'premature newborn':ti,ab OR 'premature syndrome':ti,ab OR 'prematuritas':ti,ab OR 'prematurity':ti,ab OR 'preterm baby':ti,ab OR 'preterm child':ti,ab OR 'preterm infant':ti,ab OR 'preterm neonate':ti,ab OR 'preterm newborn':ti,ab OR 'NICU':ti,ab | 803 011 |
| Intervention: | ||
| 2. | 'telemedicine'/exp OR 'tele medicine':ti,ab OR 'telemedicine':ti,ab OR 'teleconsultation'/exp OR 'remote consultation':ti,ab OR 'tele-consultation':ti,ab OR 'teleconsultation':ti,ab OR 'telephone consultation':ti,ab OR 'tele homecare':ti,ab OR 'tele care':ti,ab | 38 582 |
| Final | 1 AND 2 | 787 |
| /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | ('newborn'/exp OR 'child, newborn':ti,ab OR 'full term infant':ti,ab OR 'human neonate':ti,ab OR 'human newborn':ti,ab OR 'infant, newborn':ti,ab OR 'neonate':ti,ab OR 'neonatus':ti,ab OR 'newborn':ti,ab OR 'newborn baby':ti,ab OR 'newborn child':ti,ab OR 'newborn infant':ti,ab OR 'newly born baby':ti,ab OR 'newly born child':ti,ab OR 'newly born infant':ti,ab OR 'prematurity'/exp OR 'infant, extremely premature':ti,ab OR 'infant, premature':ti,ab OR 'infant, premature, diseases':ti,ab OR 'neonate, premature':ti,ab OR 'pre-mature infant':ti,ab OR 'pre-term baby':ti,ab OR 'pre-term child':ti,ab OR 'pre-term infant':ti,ab OR 'pre-term neonate':ti,ab OR 'pre-term newborn':ti,ab OR 'premature':ti,ab OR 'premature baby':ti,ab OR 'premature birth':ti,ab OR 'premature child':ti,ab OR 'premature childbirth':ti,ab OR 'premature infant':ti,ab OR 'premature neonate':ti,ab OR 'premature newborn':ti,ab OR 'premature syndrome':ti,ab OR 'prematuritas':ti,ab OR 'prematurity':ti,ab OR 'preterm baby':ti,ab OR 'preterm child':ti,ab OR 'preterm infant':ti,ab OR 'preterm neonate':ti,ab OR 'preterm newborn':ti,ab OR 'nicu':ti,ab) AND [embase]/lim | 543 895 |
| Intervention: | ||
| 2. | ('web-cam':ti,ab OR 'webcam':ti,ab) AND [embase]/lim | 315 |
| Final | 1 AND 2 | 6 |
| Search terms | Items found | |
| Population: | ||
| 1. | 'nicu':ti,ab AND [embase]/lim | 13 391 |
| Intervention: | ||
| 2. | ('telemedicine'/exp OR 'tele medicine':ti,ab OR 'telemedicine':ti,ab OR 'teleconsultation'/exp OR 'remote consultation':ti,ab OR 'tele-consultation':ti,ab OR 'teleconsultation':ti,ab OR 'telephone consultation':ti,ab OR 'tele homecare':ti,ab OR 'tele care':ti,ab OR 'webcam':ti,ab OR 'web-cam':ti,ab) AND [embase]/lim | 23 549 |
| Final | 1 AND 2 | 51 |
| /de= Term from the EMTREE controlled vocabulary; /exp= Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase | ||
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | (MH "Infant, Newborn") OR (MH "Infant, Low Birth Weight+") OR (MH "Infant, Premature") OR (MH "Neonatal Assessment+") OR (MH "Intensive Care, Neonatal+") OR (MH "Neonatal Intensive Care Nursing") | 125 126 |
| 2. | TI preterm OR TI newborn OR TI neonat* OR TI prematur* | 57 285 |
| 3. | AB preterm OR AB newborn OR AB neonat* OR AB prematur* | 78 779 |
| 4. | 1 OR 2 OR 3 | 174 733 |
| Intervention: | ||
| 5. | (MH "Telehealth+") OR (MH "Telephone Consultation (Iowa NIC)") | 19 713 |
| 6. | TI remote OR TI NTH OR TI telemedicine OR TI tele-care OR TI tele-homecare OR TI "tele care" OR TI "tele home care" OR TI telephone OR TI video OR TI smartphone | 21 802 |
| 7. | AB remote OR AB NTH OR AB telemedicine OR AB tele-care OR AB tele-homecare OR AB "tele care" OR AB "tele home care" OR AB telephone OR AB video OR AB smartphone | 59 468 |
| 8. | 5 OR 6 OR 7 | 83 599 |
| Final | 4 AND 8 AND published 20090101-20191231 | 1 595 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | (MH "Infant, Newborn") OR (MH "Infant, Low Birth Weight+") OR (MH "Infant, Premature") OR (MH "Neonatal Assessment+") OR (MH "Intensive Care, Neonatal+") OR (MH "Neonatal Intensive Care Nursing") | 125 671 |
| 2. | TI preterm OR TI newborn OR TI neonat* OR TI prematur* OR TI NICU | 59 045 |
| 3. | AB preterm OR AB newborn OR AB neonat* OR AB prematur* OR AB NICU | 79 795 |
| 4. | 1 OR 2 OR 3 | 176 126 |
| Intervention: | ||
| 5. | TI webcam OR TI web-cam | 36 |
| 6. | AB webcam OR AB web-cam | 92 |
| 7. | 5 OR 6 OR 7 | 111 |
| Final | 4 AND 7 | 8 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: | ||
| 1. | TI NICU | 1 769 |
| 2. | AB NICU | 4 921 |
| 3. | 1 OR 2 | 6 038 |
| Intervention: | ||
| 4. | (MH "Telehealth+") OR (MH "Telephone Consultation (Iowa NIC)") | 19 918 |
| 5. | TI remote OR TI NTH OR TI telemedicine OR TI tele-care OR TI tele-homecare OR TI "tele care" OR TI "tele home care" OR TI telephone OR TI video OR TI smartphone OR TI webcam OR TI web-cam | 21 925 |
| 6. | AB remote OR AB NTH OR AB telemedicine OR AB tele-care OR AB tele-homecare OR AB "tele care" OR AB "tele home care" OR AB telephone OR AB video OR AB smartphone OR AB webcam OR AB web-cam | 59 795 |
| 7. | 5 OR 6 OR 7 | 84 107 |
| Final | 3 AND 7 | 160 |
Projektgrupp
Detta svar är sammanställt av Jessica Dagerhamn (projektledare), Johanna Wiss (hälsoekonom), André Sjöberg (utredare), Sara Fundell (projektadministratör) samt Miriam Entesarian Matsson (produktsamordnare) vid SBU.