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A paediatric telecardiology service for district hospitals in south-east England : an observational study
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Dowie, R., Mistry, Hema, Rigby, M., Young, T. A., Weatherburn, G., Rowlinson, G. and Franklin, R. C. G. (2009) A paediatric telecardiology service for district hospitals in south-east England : an observational study. Archives of Disease in Childhood, Vol.94 (No.4). pp. 273-277. doi:10.1136/adc.2008.138495 ISSN 0003-9888.
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Official URL: http://dx.doi.org/10.1136/adc.2008.138495
Abstract
OBJECTIVES:
To compare caseloads of new patients assessed by paediatric cardiologists face-to-face or during teleconferences, and assess NHS costs for the alternative referral arrangements.
DESIGN:
Prospective cohort study over 15 months.
SETTING:
Four district hospitals in south-east England and a London paediatric cardiology centre.
PATIENTS:
Babies and children.
INTERVENTION:
A telecardiology service introduced alongside outreach clinics.
MEASUREMENTS:
Clinical outcomes and mean NHS costs per patient.
RESULTS:
266 new patients were studied: 75 had teleconsultations (19 of 42 newborns and 56 of 224 infants and children). Teleconsultation patients generally were younger (49% being under 1 year compared with 32% seen personally (p = 0.025)) and their symptoms were not as severe. A cardiac intervention was undertaken immediately or planned for five telemedicine patients (7%) and 30 conventional patients (16%). However, similar proportions of patients were discharged after being assessed (32% telemedicine and 39% conventional). During scheduled teleconferences the mean duration of time per patient in sessions involving real-time echocardiography was 14.4 min, and 8.5 min in sessions where pre-recorded videos were transmitted. Mean cost comparisons for telemedicine and face-to-face patients over 14-day and 6-month follow-up showed the telecardiology service to be cost-neutral for the three hospitals with infrequently-held outreach clinics (1519 UK pounds vs 1724 UK pounds respectively after 14 days).
CONCLUSION:
Paediatric cardiology centres with small cadres of specialists are under pressure to cope with ever-expanding caseloads of new patients with suspected anomalies. Innovative use of telecardiology alongside conventional outreach services should suitably, and economically, enhance access to these specialists.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Archives of Disease in Childhood | ||||
Publisher: | BMJ | ||||
ISSN: | 0003-9888 | ||||
Official Date: | 2009 | ||||
Dates: |
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Volume: | Vol.94 | ||||
Number: | No.4 | ||||
Page Range: | pp. 273-277 | ||||
DOI: | 10.1136/adc.2008.138495 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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