Emergency TeleNeurosurgery Physician Consultation Program and Associated Health Care Utilization Benefits.

Area of Science:

• Neurosurgery
• Health Services Research
• Telemedicine

Background:

• Hospital overcrowding and bed shortages strain healthcare systems, particularly tertiary centers (TCs).
• Unnecessary patient transfers from community hospitals to TCs exacerbate resource strain.
• Low-acuity neurological cases often contribute to these inefficient transfers.

Purpose of the Study:

• To evaluate the clinical, operational, and financial impacts of a teleneurosurgery consultation program.
• To assess the program's effectiveness in reducing unnecessary patient transfers.
• To optimize healthcare system efficiency by managing neurosurgical cases remotely.

Main Methods:

• Retrospective analysis of 324 teleneurosurgery consults over two years.
• Data collection included patient demographics, symptoms, consult outcomes, and transfer rates.
• Cost savings and revenue impacts were calculated using Medicare fee schedules and Diagnosis-Related Group data.

Main Results:

• 83.9% of consults (272/324) did not require patient transfer to the TC.
• Common cases like ground-level falls and stable intracranial hemorrhages were managed effectively without transfer.
• Significant cost savings from avoided transfers and retained revenue for community hospitals were observed, alongside preserved bed-days and financial gains for the TC.

Conclusions:

• The teleneurosurgery program effectively reduced unnecessary transfers, conserving vital healthcare resources.
• The program demonstrated significant financial benefits for both community hospitals and tertiary centers.
• Broader adoption of teleneurosurgical models can alleviate hospital capacity strain and improve healthcare efficiency.