Remote and home-based management for maintenance peritoneal dialysis patients: a retrospective cohort study using internet hospital and Four-Party Linkage models.

OBJECTIVE

To evaluate the effectiveness of the remote management based on the Internet Hospital and Family-Sicked Bed strategy under the Four-Party Linkage model among patients with maintenance peritoneal dialysis (PD).

METHODS

Bao'an People's Hospital (Group) utilized its internet hospital platform to conduct a retrospective cohort observational study on the Remote Management (RM) of PD patients. The study further established​a four-party collaborative disease management model comprising "residents-communities-community health centers-the hospital". A total of 150 insured patients were randomly assigned into three groups-Non-RM-PD group, RM-PD group, and Family-Sicked Bed group-using the random number table method. After a six-month intervention period, clinical indicators across the groups were compared, and analyses were conducted on time consumption, economic costs, as well as the potential benefits for patients, healthcare providers, and society in each group.

RESULTS

The clinical outcomes, including hospitalization rates, blood pressure levels, the proportion of patients requiring antihypertensive medications, the number of antihypertensive agents used, fluid overload, edema, hypokalemia, peritonitis incidence, and the rate of Kt/V meet the standard, demonstrated that RM-PD group and Family-Sicked Bed group were superior to the Non RM-PD group(P < 0.05). Multidimensional improvements were observed in the RM-PD and Family-Sickbed groups, such as enhanced quality of home-based PD, improved work efficiency of healthcare staff, greater social benefits, and reduced economic burden on patients. The Non RM-PD group had the highest total annual medical costs after reimbursement, whereas the Family-Sicked Bed group had the lowest (mean ± SD)(Non RM-PD = 39,383 ± 2678, RM-PD = 34,369 ± 2898, Family-Sicked Bed = 25,250 ± 2763, based on Chinese Yuan CNY, P < 0.05).

CONCLUSION

Within the 6-month follow-up period of this study, remote management supported by the internet hospital and Family-Sicked Bed management under the Four-Party Linkage model have demonstrated effectiveness in PD patients; their long-term sustainability requires further verification with extended follow-up.

CLINICAL TRIAL NUMBER: Not applicable.