Teleneurosurgery: Outcome of Mild Head Injury Patients Managed in Non-Neurosurgical Centre in the State of Johor

A questionnaire-based survey of acceptability and satisfaction of virtual neurology clinic during COVID-19 lockdown: a preliminary study

Introduction

Telemedicine during this pandemic acts as a lifeline for many non-COVID patients especially with chronic neurological diseases. The aim of present study was to evaluate cost effectiveness and level of satisfaction amongst patients from teleneurology outpatient department (OPD).

Methods

An online cross-sectional survey, having questions both in Hindi and English was conducted via telemedicine facility at Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. Demographic variables, illness details, travel distance and time taken, travel expenditure, level of satisfaction and preferred choice among tele OPD versus in-person OPD once pandemic ends were recorded.

Results

Total 1388 patients filled the online COVID-19 teleneurology survey google form. Mean age was 39.21 ± 16.72 years. Majority (N = 824, 59%) were males. Six hundred (43%) patients’ educational qualification were ≤ 10th standard. Majority of patients (N = 840, 60.5%) belonged to the rural background. Headache (N = 424, 30.5%) followed by backache (N = 220, 16%), stroke (N = 176, 13%) and seizure (N = 148, 11%) were the common illnesses. Travel time of > 5 hours was saved in 496 (36%) patients and travel expenditure of > Rs100 in 796 (57%) patients. About 96% (N = 1332) felt satisfied with the treatment advice via teleconsultation.

Discussion

Teleneurology facility is not only feasible but also affordable and acceptable in various neurological conditions. The chief reasons being no waiting time, saving of travelling time and travel expenditure with good satisfaction.

Cost-Effectiveness of Tele-Video-Consultation for the Neuro-Surgical Emergency Management at the General Hospitals in Italy

Background: Neuro-surgical emergencies are serious (long-term disability and high mortality) and costly to the national health services. Tele-medicine intervention can facilitate to reduce this gap. Our study aims to evaluate the cost-effectiveness of tele-video-consultation intervention for the management of neuro-surgical emergencies in the general hospitals. Methods: We retrieved health service data from the tele-consultation service, online tele-medicine database portal and hospital patient registry, between January 2009 and December 2012 and evaluated cost-effectiveness of the tele-video-consultation intervention from an Italian National Health Service perspective. Results: Seventy-five percent of the tele-consultations were completed within 15 min and 90% within 30 min. The average costs were €2,326 in the intervention group and €4,173 in the care as usual group. The intervention avoided 73% potential transfer (saving of 139,916 km travel distance during a 4-years period). The incremental cost-saving per transfer avoided from the tele-medicine intervention was €365. Conclusions: Tele-medicine intervention could be worth investing from the Italian National Health Service perspective.