Expansion of Telehealth Across the Rural–Urban Continuum

Bagchi, Ann D.

doi:10.1177/0160323x20929053

Cited by 8 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Additional low-barrier programs that should be incorporated into an integrated model of substance use care are outreach services and technological (i.e., mobile applications) and/or telehealth-based programs that can reach underserved PWUD, including those who reside in remote/rural areas with limited services. These programs have the potential to reduce disparities in the delivery of care, and have become increasingly utilized and integrated into the provision of substance use treatment for PWUD [ 85 , 86 ]. Extant literature highlights that mobile/telehealth is an effective low-barrier option for treatment that can result in high completion rates and client satisfaction, and has been found to decrease risky substance use practices (e.g., injection drug use) [ 85 – 87 ].…”

Section: Discussionmentioning

confidence: 99%

A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

et al. 2021

View full text Add to dashboard Cite

Background People who use drugs (PWUD) often have complex health and social support needs related to substance use, yet face numerous barriers to service access, resulting in unmet treatment needs and a corresponding gap in treatment. While initiatives to scale up substance use services for PWUD in Canada - and Ontario - have been undertaken, these have excluded PWUD’ perspectives, and their needs have largely been defined by other actors. As end-users of services, PWUD’ perspectives are vital to understanding what services are required, and whether existent services are adequate, appropriate and effective. Thus, the present study aimed to elicit in-depth knowledge from PWUD with lived experience of accessing services to better understand their unmet treatment and service needs, towards closing the service and treatment gap in Ontario. Methods This qualitative study included one-on-one interviews conducted with a cohort of n = 45 adult PWUD with substance use and treatment experience in Ontario, Canada. Participants were recruited from substance use services based on ConnexOntario’s directory of all provincial addiction services, as well as by word-of-mouth. Questions focused on participants’ experiences and perspectives on substance use services towards understanding their service needs. Data underwent an inductive thematic analysis based on key themes that emerged. Results Participants commonly engaged in polysubstance use, and identified a number of unmet substance use service needs including complex factors within the current service system that influenced access to available programs. Specifically, participants suggested the need to address stigmatization and system fragmentation, increase service provision and capacity, and scale up specific services and related supports such as harm reduction, counseling, treatment, and housing. Conclusions This study identified PWUD’ needs in relation to substance use service provision in Ontario, Canada, and highlighted important areas for policy change and program planning and implementation. Concrete recommendations include the development of a government-funded, low-barrier, comprehensive and integrated service delivery and referral models that include PWUD as collaborators and program facilitators to ensure that services are as accessible, effective, and cohesive as possible. Results from this study can be used to enhance provincial substance use treatment and service provision.

show abstract

Section: Discussionmentioning

confidence: 99%

A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The urban-rural divide influences both the level of deprivation and the outcome quality [ 69 , 70 ]. Telehealth is expected to reduce inequalities and to bridge the urban-rural divide [ 71 , 72 ] and can contribute to balancing regionally disparate capabilities for detecting atrial fibrillation. But, despite the widespread availability of the Internet and mobile devices, it cannot be excluded that layers of each of the targeted societies are without such access and are therefore disadvantaged.…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of a photopethysmographic procedure for screening for atrial fibrillation in 6 European countries

et al. 2022

View full text Add to dashboard Cite

Background Strokes cause an estimated annual health care burden of 170 billion euros across Europe. Atrial fibrillation is one of the major risk factors for stroke and increases the individual risk 4.2-fold. But prevention with anticoagulants may reduce this risk by 70%. Screening methods are employed to detect previously undetected atrial fibrillation. Screening studies in various European countries show a high degree of undetected atrial fibrillation. This study aims to assess the cost-effectiveness of systematic screening with a smartphone application, named Preventicus Heartbeats. It is a hands-on screening tool for use on smartphone to diagnose AF with high sensitivity and specificity. Methods A previously published model for calculating screening cost-effectiveness was extended to 6 European countries covering a wide range in terms of treatment costs and epidemiologic parameters. Results The use of screening lowers the cost per case in countries with comparatively high levels of health care costs (Switzerland: -€75; UK: -€7). Moderate higher costs per case were observed in 4 countries (Greece: €6; Netherlands: €15). Low levels of health care costs result in less or no potential for further cost reduction (Poland: €20; Serbia: €33). In all countries considered, the model showed an increase in effectiveness measures both in the number of strokes avoided and the quality adjusted life years. The number of strokes avoided per 1000 participants ranged from 2.52 (Switzerland) to 4.44 (Poland). Quality-adjusted life-years per case gained from screening ranged from 0.0105 (Switzerland) to 0.0187 (Poland). The screening procedure dominated in two countries (Switzerland, UK). For the remaining countries, the incremental cost effectiveness ratio ranged from €489/QALY (Greece) to €2548/QALY (Serbia). Conclusion The model results showed a strong dependence of the results on the country-specific costs for stroke treatment. The use of the investigated screening method is close to cost-neutral or cost-reducing in the Western European countries and Greece. In countries with low price levels, higher cost increases due to AF screening are to be expected. Lower costs of anticoagulation, which are expected due to the upcoming patent expiry of direct anticoagulants, have a positive effect on the cost result.

show abstract

“…Globally, healthcare disparities are frequent, with the majority of healthcare settings, such as multispecialty hospitals, located in urban regions and patients living in close proximity to the settings benefiting the most, while rural patients receive the least attention ( Bagchi, 2019 ; Harkey et al., 2020 ). Telerehabilitation through smartphone is an innovative management strategy that addresses the disparity in healthcare utilization between rural and urban areas ( Harkey et al., 2020 ).…”

Section: Discussionmentioning

confidence: 99%

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India

Bairapareddy

Alaparthi

Jitendra

et al. 2021

Heliyon

View full text Add to dashboard Cite

Background Telerehabilitation is imperative and impending in the management of chronic obstructive pulmonary disease patients. However, its feasibility in low- and middle-income nations such as India remained unclear. Objective To assess the feasibility of administering a smartphone-based telerehabilitation program for chronic obstructive pulmonary disease patients in India. Material and method An online cross-sectional survey was administered to stakeholders of the telerehabilitation program: chronic obstructive pulmonary disease patients, health care professionals including pulmonary care physicians, rehabilitation nurses and physiotherapists. The survey sought to ascertain the causes, barriers, and facilitators associated with the implementation of smartphone-based telerehabilitation, as well as strategies for practice improvement. Results While 71% (n = 37/52) of the 52 healthcare professionals surveyed were aware of smartphone-based telerehabilitation, implementation was found to be extremely low (n = 4/37; 10%). The majority of patients with chronic obstructive pulmonary disease (n = 21/30; 70%) agreed to accept smartphone-based telerehabilitation as one of their treatment options. In India, challenges to efficient telerehabilitation implementation included a lack of infrastructure, perceived time consumption, a lack of expertise and training, organizational support, and perceived inefficacy. Conclusion While knowledge of smartphone-based telerehabilitation is high among healthcare professionals and chronic obstructive pulmonary disease patients, implementation of this novel intervention measure has been limited due to perceived constraints associated with smartphone-based telerehabilitation. Adapting national and organizational policies to support smartphone-based telerehabilitation services is critical during this decade of social isolation.

show abstract

Expansion of Telehealth Across the Rural–Urban Continuum

Cited by 8 publications

References 17 publications

A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

A qualitative examination of substance use service needs among people who use drugs (PWUD) with treatment and service experience in Ontario, Canada

Cost-effectiveness of a photopethysmographic procedure for screening for atrial fibrillation in 6 European countries

"We are so close; yet too far": perceived barriers to smartphone-based telerehabilitation among healthcare providers and patients with Chronic Obstructive Pulmonary Disease in India

Contact Info

Product

Resources

About