Ronan L, Murphy K, Browne G, Connolly S, McMenamin J, Lynch B, Delanty N, Fitzsimons M
Beaumont Hospital, Dublin, Ireland.
Ir Med J. 2004 Feb;97(2):46-9.
No clinical neurophysiology (CN) service is currently provided by the North-Western Health Board (NWHB) region in Ireland. Digital technology associated with CN is compatible with tele-neurophysiology service development and may increase the efficiency of patient care in remote areas. This study was conducted to assess the need for CN in the NWHB with a view to implementing a tele-neurophysiology service for the region. A retrospective audit of investigations performed at six CN departments in Dublin compared patient groups from regions with (Eastern Regional Health Authority--ERHA) and without (NWHB) local CN departments. 4954 records were audited. CN activity was lower than internationally expected (ERHA group 52% of expected, NWHB group 23% of expected). The 2 groups differ in the specialty of referring clinician (p < 0.0001). NWHB patients are more likely to be referred by clinicians outside their region (p < 0.0001) and wait longer for appointment (p < 0.0001). While there is an unmet demand for CN services in Ireland generally, the population of the NWHB is further disadvantaged. Tele-neurophysiology has the potential to provide fairer access to CN services across the country. The data from this study provide a baseline against which the outcome of investment in CN can be monitored and evaluated.
爱尔兰西北卫生委员会（NWHB）地区目前未提供临床神经生理学（CN）服务。与CN相关的数字技术与远程神经生理学服务的发展相兼容，并且可能提高偏远地区患者护理的效率。进行这项研究是为了评估NWHB地区对CN的需求，以便为该地区实施远程神经生理学服务。对都柏林六个CN科室进行的调查进行回顾性审计，比较了设有（东部地区卫生局——ERHA）和未设有（NWHB）当地CN科室地区的患者群体。共审计了4954份记录。CN活动低于国际预期（ERHA组为预期的52%，NWHB组为预期的23%）。两组在转诊临床医生的专业方面存在差异（p<0.0001）。NWHB的患者更有可能由其所在地区以外的临床医生转诊（p<0.0001），并且等待预约的时间更长（p<0.0001）。虽然爱尔兰总体上对CN服务存在未满足的需求，但NWHB的人群处境更为不利。远程神经生理学有可能在全国范围内提供更公平的CN服务获取途径。本研究的数据提供了一个基线，据此可以监测和评估对CN的投资结果。
