虽然远程医疗通过减少感染暴露和改善功能状态不佳的患者的就诊机会而有益于肿瘤学，但它也有固有的局限性，包括无法进行体检，这可能导致这一高风险人群的下游利用增加。医疗失代偿。我们进行了一项回顾性队列研究，调查肿瘤学中远程医疗的使用与随后的肿瘤门诊患者、急诊科 (ED) 就诊和住院治疗之间的关系。我们纳入了 2018 年 1 月 1 日至2022 年 12 月 31 日在大型学术健康系统。使用未经调整的描述性统计数据和多元线性回归来根据方式（远程医疗与现场医疗）估计索引就诊后 30 天内的后续门诊肿瘤就诊、急诊就诊和住院治疗。多元回归根据各种人口和临床特征进行了调整，包括姑息治疗就诊、基线利用率、近期化疗和合并症。我们的队列包括 63,722 名患者，共 689,356 次门诊就诊，其中 639,217 名患者 (92.7%) 亲自就诊，50,139 名患者就诊。 7.3%）是远程医疗就诊。在出现指标后的 30 天内，患者平均有 0.91 次肿瘤门诊就诊、0.04 次急诊就诊和 0.05 次住院治疗。在我们的调整分析中，远程医疗与每 100 次指数遭遇中下游肿瘤门诊就诊次数减少 13.7 次（95% CI 12.5-14.9；p < 0.001）相关，每 100 次就诊次数减少 0.7 次急诊就诊次数（95% CI 0.4-1.0；p< 0.001）与亲自就诊相比，每 100 次索引就诊次数减少 0.9 次（95% CI 0.6-1.3；p < 0.001）。与我们的假设相反，进行远程医疗就诊的肿瘤患者的后续门诊肿瘤就诊次数较少， 30 天后急诊就诊和住院次数多于亲自就诊的次数。未来的研究应进一步调查远程医疗在肿瘤学中的功效，并概述在该人群和其他人群中适当使用的具体方案。

While telemedicine has been beneficial in oncology by reducing infectious exposure and improving access for patients with poor functional status, it also has intrinsic limitations, including the inability to perform a physical exam, which could lead to increased downstream utilization in this population at high risk of medical decompensation. We conducted a retrospective cohort study investigating the relationship between telemedicine use in oncology and subsequent outpatient oncology encounters, emergency department (ED) visits, and hospitalizations.We included outpatient oncology encounters, including telemedicine and in-person visits, occurring between 1 January 2018 and 31 December 2022 at a large academic health system. Unadjusted descriptive statistics and multiple linear regressions were used to estimate subsequent outpatient oncology visits, ED visits, and hospitalizations within 30 days of an index visit based on modality (telemedicine versus in-person). The multiple regressions were adjusted for various demographic and clinical characteristics, including palliative care visits, baseline utilization, recent chemotherapy, and comorbidities.Our cohort included 63,722 patients with 689,356 outpatient encounters, of which 639,217 (92.7%) were in-person and 50,139 (7.3%) were telemedicine visits. Patients on average had 0.91 outpatient oncology visits, 0.04 ED visits, and 0.05 hospitalizations within 30 days following an index encounter. In our adjusted analyses, telemedicine was associated with 13.7 fewer downstream outpatient oncology visits (95% CI 12.5-14.9; p < 0.001) per 100 index encounters, 0.7 fewer ED visits (95% CI 0.4-1.0; p < 0.001) per 100 index encounters and 0.9 fewer hospitalizations (95% CI 0.6-1.3; p < 0.001) per 100 index encounters compared to in-person visits.Contrary to our hypothesis, oncology patients who had a telemedicine visit had fewer follow-up outpatient oncology encounters, ED visits and hospitalizations after 30 days than those with in-person visits. Future studies should further investigate the efficacy of telemedicine in oncology and outline specific scenarios for appropriate use in this and other populations.