Open AccessTeleregulation in Neurology: A decision-making process for neurology evaluation in a large Brazilian city
Author(s) -
Michelle Zonkowski Ribas,
Gabriella Augustin,
Valéria Cristina Scavasine,
Renata Dal- Prá Ducci,
Marcos Christiano Lange
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.106
Subject(s) - curitiba , referral , medicine , neurology , observational study , test (biology) , family medicine , pediatrics , psychiatry , paleontology , philosophy , humanities , biology
Background: There is an increasing demand for neurological consultations. However, geographical and economic barriers and the long waiting lines limit the access. Teleregulation (TR), an asynchronous evaluation made by the neurologist, could optimize the need for presential evaluation. Objectives: The aim of this study was to analyze TR for neurological referral of patients, regarding the information provided, the main reasons for consultation, and the teleneurologist’s final decision. Design and setting: Observational cross-sectional study in Complexo Hospital de Clínicas in Curitiba-PR. Methods: The study selected neurological referrals for evaluation by TR between October 2018 and February 2020. The referrals who had incomplete information were excluded. The main variables analyzed were age, sex, reasons for TR, and final decision by the teleneurologist. Results: Of the 1035 included referrals, 56% were women and the mean age was 50±19.6 years old. The main reasons for TR were therapeutic conduct (32%), diagnosis (31%), and test request (13%) and the main specific clinical reasons were headache (30%), epilepsy (19%), dementia (16%), cerebrovascular diseases (11%), and neuromuscular disorders (10%). More information was requested in 427 (41%) of the consults and no need for in-person consultation occurred in 713 (68%) of cases. Conclusions: The main reasons for TR were management and diagnosis. The study showed that TR can reduce the need for presential assessment by a neurologist in more than two-thirds of cases. However, a great part of the consultations needed additional data. Thus, the optimization of the referrals could further improve this system, reducing its overhead.