An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children

Jacups, Susan P.; Newman, Denise; Dean, Deborah; Richards, Ann; McConnon, Kate M.

doi:10.1016/j.ijporl.2017.07.011

Cited by 16 publications

(59 citation statements)

References 47 publications

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“…Further improvements have also been demonstrated for patients due to improved efficiencies, such as shorter wait times for ENT services, and less time lost from travel or missed appointments . A recent Australian study on ENT surgery, using TeleHealth for post‐operative review, identified a minimum cost saving of AUD$21 664 . TeleMedicine has been used extensively for ENT pre‐surgery planning and post‐surgical review across remote areas of Alaska .…”

Section: Discussionmentioning

confidence: 99%

“…The study aims to identify the least‐cost approach by funding source. We compare the costs of standard service delivery (model 1), against the service model recently described (model 2), with an alternative model of surgical access and care that includes ear and hearing health (EH) team and TeleHealth for pre‐post‐surgical reviews (model 3). Costs are assessed from two viewpoints: (1) health system perspective, and (2) patients and their families including travel out‐of‐pocket expenses.…”

Section: Methodsmentioning

confidence: 99%

“…This model offered a fast track pathway to ENT surgery initiated after patients faced excessive wait times. Further details about the study have been previously published . While model 2 costs are based on the actual budget expenses, model 1 and model 3 costs are extrapolated costs for the same cohort of 16 patients presented in model 2.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, high rates of severe OM with associated hearing loss are reported across the region. School screening from 2012 to 2013 indicates that 7% of primary school children had ear perforations in one or both ears and 12% reported hearing loss of ≥35 dB in one or both ears …”

Section: Methodsmentioning

confidence: 99%

“…We recently reported a strategy to improve access to surgery for a cohort of 16 Torres Strait and Cape York children who required access to ENT surgery. This new service strategy was initiated after children (patients) faced excessive wait times for their elective ENT surgery . In this surgery cohort, patients were offered an innovative service pathway delivered through the private health system, which was co‐funded by several health organizations (model 2 in the current article).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Ear, nose, and throat surgical access for remote living Indigenous children: What is the least costly model?

Jacups

Kinchin

McConnon

2018

Evaluation Clinical Practice

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Rationale, aims, and objectives: This costing evaluation compares three service delivery models for ear, nose, and throat (ENT) surgery for remote living Indigenous children to improve their hearing outcomes, with the aim to identify the least costly model. Methods:The main outcome measure presented was the incremental cost difference between the base case (Model 1) and two alternative models (Model 2, 3). The costs in 2017 Australian dollars are assessed from two viewpoints: (1) health system perspective, and (2) patients and their families including travel out-of-pocket expenses, presented separately according to the funding source.Results: Findings indicate that the least costly model offered low-risk ENT surgery from a state funded hospital in a remote setting, with high use of videoconference technology: TeleHealth (Model 3) could save $3626 to $5067 per patient, compared with patients travelling to a regional centre public hospital (Model 1). A federally funded scheme which allowed groups of patients to access a direct flight charter transfer to the private hospital in regional centre (Model 2) reduced the cost by $2178 to $2711 per patient when compared with standard care (Model 1). From a societal perspective, Model 1 required out-of-pocket patient expenses, with greater time away from home, and hence appears the least preferred option. Conclusions:The sensitivity analyses also demonstrate that Model 3 would be the more economical model for providing ENT surgery for remote living children. By proving an accurate assessment of the true costs of delivering these important ear and hearing health services, strategic health service planners may be better informed and sufficient budgets can be allocated to provide improved service delivery. The benefits of Model 3, over Models 1 or 2, would also incorporate improvements to patient safety as a result of reducing patient travel, which should in-turn, reduce failure-to-attend rates. KEYWORDSaudiometry, cost, model of care, otitis media with effusion/*therapy, otologic surgical procedures, TeleHealthThis study was undertaken at

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ear, nose, and throat surgical access for remote living Indigenous children: What is the least costly model?

Jacups

Kinchin

McConnon

2018

Evaluation Clinical Practice

Self Cite

View full text Add to dashboard Cite

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Systematic Review of Telehealth Cost Minimization for Patients and Health Systems in Otolaryngology

et al. 2020

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Objective/Hypothesis: The COVID-19 pandemic has resulted in telehealth becoming commonplace in many health care fields. Telehealth benefits include improving access, decreasing costs, and elevating patient's experience. A review of cost minimization (CM) analyses was performed in order to explore scientific studies associated with integrating tele-otolaryngology in clinical practice. Our primary objective was to evaluate published literature for cost related to the implementation of telemedicine across otolaryngology, and to determine CM when compared to in-person visits.Study Design: Systematic Literature Review. Methods: We performed a systematic review using PubMed, EMBASE, and Cochrane in May 2020, to identify studies with a cost analysis of tele-otolaryngology care. Inclusion criteria focused on articles citing CM data from telehealth services. Literature quality was assessed using the MINORS scoring system.Results: From 380 original articles screened only nine evaluated cost in otolaryngology. CM in the US ranged from $68 to $900 per visit. Cost was evaluated in general otolaryngology, sleep medicine, otology, and head and neck cancer surgery, the latter had the most benefit. The most common types of telehealth visits were routine follow-up and screening. Data were insufficient for meta-analysis.Conclusions: Telemedicine has been trialed across various otolaryngology subspecialties; its incorporation is projected to have a meaningful impact on access to specialty care. This research suggests that the delivery of virtual care reduces cost with the potential of increasing net revenue across multiple otolaryngology subspecialties. Further studies are needed to better discern the entirety of cost savings and the best settings for integration.

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A systematic review of remote otological assessment using video-otoscopy over the past 10 years: reliability and applications

Metcalfe

Muzaffar

Orr

et al. 2021

Eur Arch Otorhinolaryngol

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Purpose This systematic review describes and evaluates the current literature on remote otological assessment using videootoscopy with regards to reliability and potential applications. Methods Systematic review was conducted in accordance with the PRISMA statement. There was heterogeneity of included studies, so a descriptive analysis was undertaken. Results Seventeen studies were included for analysis conducted across a variety of healthcare settings. Overall, there was a trend towards acquisition of adequate images for diagnosis by non-otolaryngology-specialist facilitators with reasonable agreement between asynchronous images and controls; however, there was significant variation between the studies. Conclusion Remote otological assessment using video-otoscopy shows potential as a safe and effective method for detecting the presence of ear disease in a wide range of healthcare settings. Barriers to the acquisition of adequate images include the presence of obstructing cerumen, and strategies to deal with this should be considered. Further work is required to evaluate endoscope-based systems to assess whether they will allow the acquisition of higher quality images.

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An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children

Cited by 16 publications

References 47 publications

Ear, nose, and throat surgical access for remote living Indigenous children: What is the least costly model?

Ear, nose, and throat surgical access for remote living Indigenous children: What is the least costly model?

Systematic Review of Telehealth Cost Minimization for Patients and Health Systems in Otolaryngology

A systematic review of remote otological assessment using video-otoscopy over the past 10 years: reliability and applications

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