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1.
Aust Health Rev ; 46(2): 255, 2022 Apr.
Article in English | MEDLINE | ID: mdl-35389836

ABSTRACT

Objective This study determined caregivers' evaluations of telehealth consultations for their child, preference over in-person consultations and potential cost savings by child condition, family socioeconomic status and location. Methods A survey was conducted of 2436 caregivers attending a telehealth consultation with their child for a broad group of conditions between 3 June and 25 August 2020 at a tertiary paediatric hospital in Melbourne, Australia. Results Most caregivers found telehealth consultations convenient, acceptable, safe and private, and capable of answering their questions and concerns. However, caregivers who spoke a language other than English and patients attending for behavioural and mental health, developmental or other (e.g. allied health) concerns were more likely to prefer in-person consultations over telehealth. Mean (±s.d.) reported cost savings on caregiver time were A$144.98 ± 99.04 per family per consultation, whereas mean (±s.d.) transport cost savings were A$84.90 ± 100.74 per family per consultation. Cost savings were greatest for families living in low and middle socioeconomic areas and regional or rural areas. Conclusions Paediatric telehealth video consultations were largely viewed favourably by caregivers, except for those attending for behavioural and mental health or developmental concerns. What is known about the topic? Adult consumers of telehealth consultations view them as useful, convenient and cost saving, but less is known about caregivers' evaluations of telehealth consultations and potential cost savings for paediatric patients, and whether these differ by family location, socioeconomic status or child condition. What does this paper add? This is the first Australian paper to report on caregivers' evaluations across a range of paediatric conditions and locations. Most caregivers found telehealth consultations convenient, safe, acceptable, able to answer their questions and concerns about their child's health and cost saving. What are the implications for practitioners? Caregivers of children with behavioural, mental health or developmental problems were less likely to prefer telehealth over in-person consultations, so practitioners should consider providing such consultations in person.

2.
Aust Health Rev ; 46(2): 197-203, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34656185

ABSTRACT

Objective This study determined caregivers' evaluations of telehealth consultations for their child, preference over in-person consultations and potential cost savings by child condition, family socioeconomic status and location. Methods A survey was conducted of 2436 caregivers attending a telehealth consultation with their child for a broad group of conditions between 3 June and 25 August 2020 at a tertiary paediatric hospital in Melbourne, Australia. Results Most caregivers found telehealth consultations convenient, acceptable, safe and private, and capable of answering their questions and concerns. However, caregivers who spoke a language other than English and patients attending for behavioural and mental health, developmental or other (e.g. allied health) concerns were more likely to prefer in-person consultations over telehealth. Mean (±s.d.) reported cost savings on caregiver time were A$144.98 ± 99.04 per family per consultation, whereas mean (±s.d.) transport cost savings were A$84.90 ± 100.74 per family per consultation. Cost savings were greatest for families living in low and middle socioeconomic areas and regional or rural areas. Conclusions Paediatric telehealth video consultations were largely viewed favourably by caregivers, except for those attending for behavioural and mental health or developmental concerns. What is known about the topic? Adult consumers of telehealth consultations view them as useful, convenient and cost saving, but less is known about caregivers' evaluations of telehealth consultations and potential cost savings for paediatric patients, and whether these differ by family location, socioeconomic status or child condition. What does this paper add? This is the first Australian paper to report on caregivers' evaluations across a range of paediatric conditions and locations. Most caregivers found telehealth consultations convenient, safe, acceptable, able to answer their questions and concerns about their child's health and cost saving. What are the implications for practitioners? Caregivers of children with behavioural, mental health or developmental problems were less likely to prefer telehealth over in-person consultations, so practitioners should consider providing such consultations in person.


Subject(s)
Caregivers , Telemedicine , Adult , Australia , Child , Cost Savings , Humans , Referral and Consultation , Telemedicine/methods
3.
Arch Dis Child ; 101(10): 886-93, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27166221

ABSTRACT

OBJECTIVE: Outpatient parenteral antimicrobial therapy (OPAT) is increasingly used to treat children at home, but studies in children are scarce. We aimed to describe the use, appropriateness and outcomes of OPAT in children. DESIGN: This was a 12-month prospective observational study. SETTING: The hospital-in-the-home programme of The Royal Children's Hospital Melbourne. PATIENTS: All patients receiving OPAT. INTERVENTIONS: Data were collected including demographics, diagnosis, type of venous access and antibiotic choice. MAIN OUTCOME MEASURES: Length of stay, adverse events, readmission rate and appropriateness of antibiotic use. RESULTS: 228 patients received OPAT in 251 episodes. The median age was 7.4 years (range 1 week to 21 years), with 22 patients (10%) under 1 year. The most frequent diagnoses were exacerbation of cystic fibrosis (17%), urinary tract infection (12%) and cellulitis (9%). Most patients were transferred from the ward, but 18% were transferred directly from the emergency department, the majority with skin and soft-tissue infection (66%). Venous access was most commonly peripherally inserted central catheter (29%) and peripheral cannula (29%). 309 parenteral antibiotics were prescribed, most frequently ceftriaxone (28%) and gentamicin (19%). The majority of antibiotics (72%) were prescribed appropriately. However, 6% were deemed an inappropriate choice for the indication and 26% had inappropriate dose or duration. The incidence of central line-associated bloodstream infections was 0.9%. The unplanned readmission rate was 4%, with low rates of OPAT-related adverse events. Three children (1%) had an inadequate clinical response. CONCLUSIONS: OPAT is a safe and effective way of providing antibiotics to children. Despite high rates of appropriate antibiotic use, improvements can still be made.


Subject(s)
Anti-Infective Agents/administration & dosage , Adolescent , Ambulatory Care/statistics & numerical data , Bacterial Infections/drug therapy , Candidiasis/drug therapy , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous/statistics & numerical data , Catheterization, Peripheral/adverse effects , Catheterization, Peripheral/statistics & numerical data , Ceftriaxone/administration & dosage , Cellulitis/drug therapy , Child , Child, Preschool , Cystic Fibrosis/drug therapy , Female , Gentamicins/administration & dosage , Humans , Infant , Infant, Newborn , Infusions, Intravenous , Infusions, Parenteral , Length of Stay/statistics & numerical data , Male , Patient Readmission/statistics & numerical data , Prescription Drugs/administration & dosage , Prospective Studies , Referral and Consultation/statistics & numerical data , Treatment Outcome , Urinary Tract Infections/drug therapy , Young Adult
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