Reducing Loss to Follow-Up with Tele-audiology Diagnostic Evaluations
Reducing Loss to Follow-Up with Tele-audiology Diagnostic Evaluations
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DOI：
10.1089/tmj.2015.0001
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发表时间：
2016-02-01
影响因子：
4.7
通讯作者：
Marcin, James P.
中科院分区：
文献类型：
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作者：
Dharmar, Madan;Simon, Anne;Marcin, James P.
背景资料：未通过新生儿听力筛查的婴儿需要进行诊断随访，但通常面临访问障碍，例如旅行距离和儿科听力学家短缺。远程医疗（远程听力学）是为面临访问障碍的婴儿家庭提供诊断性听力评估的潜在解决方案。我们确定了远程听力学项目的可行性和影响，该项目为未通过新生儿听力筛查的新生儿中失访率较高的地区提供了全面的诊断评估。材料与方法：我们评估了远程听力学计划使用父母和供应商的调查，以确定质量和满意度的护理的看法。我们还比较了失访率的远程听力学计划与损失的后续行动在该地区之前，该计划的实施。结果：22名未通过新生儿听力筛查的婴儿被转介到远程听力学项目进行诊断评估。在这些婴儿中，59.1%被诊断出患有某种形式的听力损失。父母和提供者对远程医疗互动的平均质量评分在7分制的李克特量表上超过6.5分。所有父母都将远程听力学的重要性评为7（非常重要），而提供者在7点Likert量表上将平均重要性评为6.4（95%置信区间，5.9，6.9）。几乎所有家长都积极参与或参与历史记录和咨询，并且愿意通过远程医疗远程讨论孩子的听力状况。所有婴儿都完成了诊断评估，没有失访，而在该计划实施前，该地区的失访率为22%。结论：远程听力学是一种可行的解决方案，可以减少未通过新生儿听力筛查且无法获得合格听力学家诊断评估的婴儿的随访损失。
Background: Infants who do not pass their newborn hearing screen require diagnostic follow-up visits but often face access barriers such as travel distance and shortage of pediatric audiologists. Telemedicine (tele-audiology) is a potential solution to provide diagnostic hearing evaluations for families of infants facing access barriers. We determined the feasibility and impact of a tele-audiology program that provided comprehensive diagnostic evaluations to a region with a high lost to follow-up rate among newborns who did not pass their newborn hearing screen. Materials and Methods: We evaluated the tele-audiology program using parent and provider surveys to determine the perception of quality and satisfaction of care. We also compared the lost to follow-up rate of the tele-audiology program with the loss to follow-up in the region before the implementation of the program. Results: Twenty-two infants who did not pass their newborn hearing screen were referred to the tele-audiology program for diagnostic evaluation. Among these infants, 59.1% were diagnosed with some form of hearing loss. The mean quality score rated by both parents and providers on the telemedicine interaction was over 6.5 on a 7-point Likert scale. All parents rated the importance of tele-audiology as 7 (extremely important) for their family, whereas the provider rated the mean importance as 6.4 (95% confidence interval, 5.9, 6.9) on a 7-point Likert scale. Almost all parents actively participated or were engaged during history taking and counseling and were comfortable in discussing their child's hearing status remotely over tele-medicine. All infants completed their diagnostic evaluation with no loss to follow-up compared with 22% loss to followup in the region before the implementation of the program. Conclusions: Tele-audiology is a feasible solution that reduces the loss to follow-up among infants who do not pass their newborn hearing screen and have access barriers to qualified audiologists for diagnostic evaluations.