Abstract:

Objective This study analyzes the current application status of 2 service models online consultation and home-based nursing care for wound patients，aiming to provide a basis for formulating precise management strategies.Methods A retrospective study design was employed to collect wound care service data from the “Internet + Nursing Services” platform of a tertiary hospital in Zhejiang Province between January 1，2023 and December 31，2024. A total of 1 170 patients were included，generating 1，797 service episodes（1，008 online consultations cases involving 1，818 consultation entries，and 789 home-based care episodes）. Consultation content was categorized using content analysis. Inter-group comparisons were performed using the χ² test，t-test，and Mann-Whitney U test. Descriptive methods were used to analyze service characteristics and demand distributions.Results Patients in the online consultation group were younger and had a shorter median time since wound onset compared to the home-based care group（all P<0.01）. The distribution of wound types differed significantly between groups（P<0.001）. Online consultations were predominantly for iatrogenic wounds（96.27%）. With 78.66% of consultations occurring within 14 days post-injury，primarily focusing on symptom management，wound assessment，and technical guidance. The composition of consultation content varied significantly across wound types（P<0.001）. The problem resolution rate for online consultations was 78.16%，with significant differences across wound types and consultation themes（all P<0.001）. For home-based care，patients with high-frequency demands（≥3 service episodes） had significantly higher age，larger wound area，and a higher proportion of complex wound care procedures compared to those with low-frequency demands（all P<0.05）.Conclusion The online consultation and home-based care models for “Internet + wound care” are characterized by distinct features and complementary functions. It is recommended to develop an intelligent triage and referral pathway based on wound characteristics，formulate personalized health education strategies aligned with the dynamic evolution of patient needs，and establish a risk-stratified management mechanism for patients with high-frequency home-based care demands.

Key words: Internet+, Wound Care, Online Consultation, Home-Based Nursing Care, Transitional Care

摘要：

目的 分析伤口患者线上咨询与居家上门服务2种模式的应用现状，为制订精准管理策略提供依据。方法 收集浙江省某三级甲等医院2023年1月—2024年12月通过“互联网+”护理服务平台产生的伤口护理服务数据。纳入患者1 170例，累计服务1 797例次，其中线上咨询1 008例次（咨询条目1 818条），居家上门服务789例次。采用内容分析法对咨询文本进行归类；采用χ²检验、t检验、Mann-Whitney U检验进行组间比较；采用描述性方法分析服务特征与需求分布。结果 线上咨询组较居家上门服务组更年轻、距伤口发生时间更短，两组差异具有统计学意义（均P<0.01）。两组伤口类型构成差异具有统计学意义（P<0.001），线上咨询组以医源性伤口为主（96.27%）。78.66%的线上咨询来自伤后14 d内，内容以症状管理、评估与技术指导为主，且不同类型伤口的咨询主题分布差异具有统计学意义（P<0.001）。线上咨询整体解决率为78.16%，不同伤口类型与咨询主题的解决率差异具有统计学意义（均P<0.001）。居家上门服务中，服务频次≥3次的患者（高频组）在年龄、伤口面积及复杂创面护理比例方面均高于服务频次1~2次的患者（低频组），差异具有统计学意义（均P<0.05）。结论 线上与居家上门服务模式特征鲜明、功能互补，建议未来构建以伤口特征为导向的智能分诊与转诊路径，开展契合需求动态的个性化健康教育，并针对高频居家上门服务群体建立风险分层管理机制。

关键词: 互联网+, 伤口护理, 线上咨询, 居家上门护理, 延续护理