The cost-effectiveness of teleneurology consultations for patients admitted to hospitals without neurologists on site. 1: A retrospective comparison of the case-mix and management at two rural hospita...
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Date
2000-05-25
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Abstract
We are currently evaluating the use of telemedicine for improving the care of patients admitted with neurological symptoms to hospitals that do not have specialist neurologists on site To do this we have been comparing the outcome of patients admitted to two small hospitals In one hospital all patients with neurological symptoms are seen by a neurologist at a distance using an interactive video link transmitting at 384 kbit s in the other patients with neurological problems are managed as per usual practices For the results of this study to be valid it is essential that the case mix and process of management for neurological patients are similar at the two hospitals We therefore compared the case mix process of management and outcome for all patients admitted over a four month period to either hospital who had been coded using ICD 10 as having a final diagnosis of a neurological condition No appreciable differences were noted between the two hospitals for measures of case mix or outcome Likewise most measures of process were similar although there was a significant difference for the overall length of hospital episode between the two hospitals When patients with prolonged hospital episodes were excluded or only patients with a diagnosis of headache epilepsy or transient ischaemic attack were considered who as a group made up the bulk of neurological admissions the difference in the length of hospital episode was not significant It should therefore be possible for us to estimate the effect of telemedicine on the management of patients with neurological problems