Pre-surgery evaluations by telephone decrease travel and cost for families of children with cerebral palsy

Area of Science:

• Pediatric Orthopedics
• Telemedicine
• Healthcare Access

Background:

• Children with cerebral palsy require specialized care, often involving long-distance travel for families.
• Rural populations face significant burdens due to travel for medical appointments.
• Selective percutaneous myofascial lengthening surgery necessitates pre-operative assessments.

Purpose of the Study:

• To evaluate the effectiveness of telephone-based telemedicine for surgical eligibility assessment.
• To quantify reductions in travel mileage, expenses, and carbon emissions.
• To determine the accuracy of telephone assessments in identifying surgical candidates.

Main Methods:

• Retrospective review of 279 patients (2010-2012) undergoing telephone screening and X-rays.
• Geographic Information System (GIS) used for mileage and cost calculations.
• Prospective study of 195 patients (2014-2015) to assess accuracy and effectiveness.

Main Results:

• Saved 106,070 miles and $55,326 over 3 years, a 38% reduction.
• Families saved an average of 658 miles and $343.64 per visit.
• Increased distance from the health center correlated with higher telephone screening utilization (OR: 1.101).
• 86% of patients were deemed likely surgical candidates via telephone prescreening.

Conclusions:

• Telephone-based telemedicine is an effective and accurate method for assessing surgical eligibility.
• This approach significantly reduces travel burden for families of children with cerebral palsy.
• The method offers substantial cost savings and improved healthcare access for specialized surgical care.