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建立远程和农村北领地澳大利亚儿科睡眠健康的远程医疗模式:克服距离障碍。

Establishing a telehealth model addressing paediatric sleep health in remote and rural Northern Territory Australia: Overcoming the distance barrier.

机构信息

Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia.

Sydney Children's Hospital, Sydney, New South Wales, Australia.

出版信息

J Paediatr Child Health. 2024 Jun;60(6):212-221. doi: 10.1111/jpc.16549. Epub 2024 May 10.

Abstract

AIM

This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non-Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia.

METHODS

Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020.

RESULTS

Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non-Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status - (non-Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy.

CONCLUSIONS

This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.

摘要

目的

本研究考察了远程健康模式在澳大利亚北部地区偏远和区域社区中对土著和非土著儿童睡眠健康评估的效果。

方法

通过视频远程健康咨询,由州际儿科睡眠医师远程进行临床病史和相关体格检查评估。在达尔文进行多导睡眠图(PSG)和治疗干预。研究参与者为 2015 年至 2020 年间转诊的儿童。

结果

在总共 812 名接受睡眠评估的儿童中,699 名进行了诊断性 PSG。大多数患者为女性(63%),非土著(81%),居住在偏远地区(88%)。土著儿童年龄明显较大,居住在偏远或极偏远地区(22%比 10%)。根据地理位置和土著身份,转诊模式有所不同-(非土著通过私人途径(53%),土著通过公共系统(35%))。接受初始咨询的转诊中位数为从咨询到 PSG 的 16 天和 4 周。偏远地区儿童的转诊和初始咨询之间的时间延迟略长(32 天比 15 天)。51%被诊断为 OSA,27%接受了腺样体扁桃体切除术,2%接受了 CPAP 治疗。

结论

本研究表明,远程健康模式是克服后勤障碍并为澳大利亚偏远和地区的儿童提供睡眠健康服务的有效方法。需要进一步创新努力来改善服务模式,并扩大为非常偏远社区的弱势儿童提供服务的范围。

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