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退伍军人事务国家远程神经病学计划 (NTNP) 改善了神经病学准入. 在VA医疗中心使用较高的NTNP与当地神经科医生减少,诊所日数增加或中风患者数量减少有关.

关键词:
实施科学 实施科学神经学 神经学 神经学农村卫生服务 农村卫生服务远程医疗远程医疗

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科学领域:

  • 神经学 神经学
  • 医疗保健服务研究 医疗服务研究
  • 远程医疗远程医疗

背景情况:

  • 退伍军人事务国家远程神经病学计划 (NTNP) 成立,旨在通过远程医疗改善门诊神经病学服务.
  • 之前的研究表明,NTNP可以减少等待时间,社区护理咨询和旅行负担,同时提高满意度.

研究的目的:

  • 为了确定区分VA医疗中心 (VAMCs) 具有高与低使用NTNP的设施级条件,对中风患者进行咨询.
  • 了解影响远程健康神经病学服务成功实施的因素.

主要方法:

  • 对VA远程医疗质量改善计划进行了混合方法评估.
  • 配置比较方法分析了行政记录,设施特征,领导层参与和采访.
  • 该研究将NTNP咨询与社区护理神经病学 (CCN) 咨询进行了对中风诊断的比较,重点是NTNP咨询的比例.

主要成果:

  • 具有高NTNP使用率 (≥22.4%) 的设施的特点是缺乏当地VA神经科医生,更多的NTNP诊所日 (≥0.65/周),或较低的年度中风患者数量.
  • 这些配置足以实现高NTNP采用.
  • 研究结果表明,对人员和诊所可用性的有针对性的调整可以增加NTNP的使用,特别是在当地神经病学服务有限的地方.

结论:

  • 加强NTNP实施的战略框架包括将设施资源与计划目标保持一致,考虑中风量和当地神经病学可用性.
  • 与使用较少的原因相比,NTNP的高使用率成功实施似乎有更直接的途径.