Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
Télécharger le rapport (152 p.) - KCE
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
94 Urgences <strong>KCE</strong> reports vol. 19B<br />
FIRST AUTHOR-<br />
YR-CTRY.<br />
SHEPPERD S.-<br />
2001-UK.<br />
TACHAKRA S.-<br />
2000-UK.<br />
TACHAKRA S.-<br />
2002-UK.<br />
VAN HOECK<br />
K.-2002-BEL.<br />
TYPE STUDY OBJECTIVE(S) METHOD(S) RESULTS DISCUSSION<br />
Cochrane based<br />
systematic<br />
review.<br />
Wide ranging<br />
view study.<br />
Case control<br />
study.<br />
Report about a<br />
pilot project in a<br />
defined area.<br />
Assessing the hospital at home versus<br />
in-patient hospital care.<br />
Describing and arguing the different<br />
models of te<strong>le</strong>medicine,the possib<strong>le</strong><br />
dispositions of services.<br />
Accuracy and reliability of<br />
te<strong>le</strong>consultations (radiographs) in a<br />
minor injury unit one year(casual use)<br />
and over a 4 yr period afterwards.<br />
Studying a common organisation of<br />
duty primary and secondary<br />
emergency services.<br />
Systematic se<strong>le</strong>ction of the randomized<br />
trials, using the Cochrane effective<br />
practice and organisation of care grp.<br />
and extraction of data- assessing study<br />
quality by 2 reviewers.<br />
Reasons, technological advances,<br />
disposition of the useful potential users,<br />
subjected to doub<strong>le</strong> peer review.<br />
Over the 4 yrs 3,6 % of consults (mainly<br />
fractures,infections,<strong>le</strong>ss chest pain) were<br />
performed with te<strong>le</strong>medicine. Half of the<br />
cases were done by reason of<br />
te<strong>le</strong>radiology for fractures. Image clarity<br />
was judged satisfactory in 88 %; sound<br />
clarity in 77%.<br />
Stepwise approach of a task sharing<br />
between GPCO and GP rotasystems and<br />
EDÊs in the region of Leuven-BE.<br />
16 trials retained. No different patient outcomes<br />
for elderly pats with a mix of medical conditions<br />
and pats recovering from e<strong>le</strong>ctive surgery. More<br />
conflicting are these recovering from stroke.<br />
more independence at home but <strong>le</strong>ss<br />
psychosocial communication, pats prefer home<br />
hospital and carers the opposite, more <strong>le</strong>ngth of<br />
treatment in the hospital at home grp.<br />
Additional peripherals (fe. E<strong>le</strong>ctronic<br />
gloves,multidimensional<br />
oftalmoscopes..),automatic call redirection and<br />
instruction for further investigation,pattern<br />
recognition for diagnostics(ECG), automatic<br />
teaching,fasrer links are recnet applicab<strong>le</strong><br />
tecnological advances in te<strong>le</strong>medicine.<br />
Te<strong>le</strong>medicine needs additional training especially<br />
for nurses specialising in this new field.·<br />
Te<strong>le</strong>medicine can save a referral to ED in 90 % of<br />
bone injuries and infections.·Te<strong>le</strong>medicine<br />
reduces significantly the workload of GPÊs and<br />
EDÊs..<br />
10 key messages are addressed to fullfill an<br />
optimal task description of the different <strong>le</strong>vels of<br />
emergency care dealing with PC<br />
centres,infochannels, public awareness, modern<br />
technology, unsafety, inclusion of other<br />
paramedicals, financial subsidies.<br />
This review donÊt support the<br />
hospital at home services as<br />
cheaper than in-patient<br />
care.Future research will hav<br />
eto focus on admission<br />
avoidance schemes,and the<br />
effect of early discharge<br />
hospital at home schemes for<br />
pats recovering from a stroke.<br />
The te<strong>le</strong>medicine can be used<br />
by GPCOÊs,chemists, NHS<br />
direct,paramedic<br />
management,walk-in centres,<br />
minor injury units,emergency<br />
rooms and ambulances,senior<br />
consultants in residnece in<br />
secondary hospitals.<br />
Te<strong>le</strong>medicine is an excel<strong>le</strong>nt<br />
educational tool and the<br />
spectrum of cases that Enurses<br />
see has been enlarged<br />
and their practical skill<br />
extended.<br />
This practical guidelines are a<br />
interesting and novative<br />
initiative to enhance the<br />
better compliance between<br />
emergency PC and SC to be<br />
replicab<strong>le</strong> across teh borders.