Wu Tzu-Ching, Lyerly Michael J, Albright Karen C, Ward Eric, Hassler Amanda, Messier Jessica, Wolff Catherine, Brannas Charles C, Savitz Sean I, Carr Brendan G
Stroke Program, Department of Neurology, University of Texas-Houston Memorial Hermann Medical Center, Houston, TX 77030.
Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294.
Ann Clin Transl Neurol. 2014 Jan 1;1(1):27-33. doi: 10.1002/acn3.20.
To examine the impact of telemedicine on access to acute stroke care and expertise in the state of Texas.
Texas hospitals were surveyed using a standard questionnaire and categorized as: (1) stand-alone Primary Stroke Centers not using telemedicine for acute stroke care, (2) Primary Stroke Centers using telemedicine for acute stroke care, (3) non-Primary Stroke Center hospitals using telemedicine for acute stroke care, or (4) non-Primary Stroke Center hospitals not using telemedicine for acute stroke care. Population data were obtained from the US Census Bureau and the Neilson Claritas Demographic Estimation Program. Access within 60 minutes to a designated facility was calculated at the block group level.
Over 75% of Texans had 60-minute access to a stand-alone Primary Stroke Center. Including Primary Stroke Centers using telemedicine increased access by 6.5%. Adding non- Primary Stroke Centers that use telemedicine for acute stroke care provided 60-minute access for an additional 2% of Texans, leaving 16% of Texans without 60-minute access to acute stroke care. Approximately 62% of Texans had 60-minute access to more than one type of facility that provided acute stroke care.
The use of telemedicine in the state of Texas brought 60-minute access to >2 million Texans who otherwise would not have had access to acute stroke expertise. Our findings demonstrate that using telemedicine for acute stroke has the ability to provide neurologically underserved areas access to acute stroke care.
研究远程医疗对德克萨斯州急性中风护理可及性和专业水平的影响。
使用标准问卷对德克萨斯州的医院进行调查，并将其分类为：（1）不使用远程医疗进行急性中风护理的独立初级中风中心；（2）使用远程医疗进行急性中风护理的初级中风中心；（3）使用远程医疗进行急性中风护理的非初级中风中心医院；或（4）不使用远程医疗进行急性中风护理的非初级中风中心医院。人口数据来自美国人口普查局和尼尔森克拉里塔斯人口估计项目。在街区组层面计算60分钟内到达指定机构的可及性。
超过75%的德克萨斯人在60分钟内可到达独立的初级中风中心。将使用远程医疗的初级中风中心包括在内，可及性提高了6.5%。增加使用远程医疗进行急性中风护理的非初级中风中心，又为另外2%的德克萨斯人提供了60分钟内的可及性，仍有16%的德克萨斯人在60分钟内无法获得急性中风护理。约62%的德克萨斯人在60分钟内可到达不止一种提供急性中风护理的机构。
在德克萨斯州使用远程医疗，使超过200万原本无法获得急性中风专业护理的德克萨斯人能够在60分钟内获得护理。我们的研究结果表明，将远程医疗用于急性中风能够为神经科服务不足的地区提供急性中风护理。
