Telemedicine Rounding Support for Public Health System Pediatric Intensive Care Units in Brazil can Improve Outcomes.

Autor:	Jacovas VC; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Constant HMRM; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Matte MCC; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Crivella CG; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Chagas MEV; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Fröhlich GC; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Krauzer JRM; Pediatrics Service, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Guerra LR; Pediatrics Service, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Pires AA; Pediatrics Service, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., da Cunha LG; Pediatrics Service, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Moreira TC; Institutional Development Program of the Brazilian National Health System (PROADI-SUS), Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil., Cabral FC; Pediatrics Service, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil.; Digital Health Medical Management, Hospital Moinhos de Vento (HMV), Porto Alegre, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of intensive care medicine [J Intensive Care Med] 2024 Sep 09, pp. 8850666241268842. Date of Electronic Publication: 2024 Sep 09.
DOI:	10.1177/08850666241268842
Abstrakt:	There are discrepancies in resources and expertise available between pediatric intensive care units (PICUs) in Brazil that likely significantly impact the clinical outcomes of patients. The goal of this study was to evaluate the impact of telemedicine rounding support in two public PICUs located in the North and Northeast regions of Brazil. Our intervention involves telehealth rounds connecting two "level II" PICUs with specialist doctors from a hospital of recognized excellence. A before-and-after study was carried out to evaluate telemedicine's impact on PICUs between December 2018 and July 2019. Nine hundred and forty patients were evaluated during this period (426 pre-telemedicine, 514 post-telemedicine). The intervention occurred through telerounds between the command center and the ICUs assisted by telemedicine. In unit A, the implementation of telemedicine reduced the mortality rate from 18.86% to 9.29%, while in unit B, it decreased from 10.76% to 9.72%. There was no change in the median length of stay in unit A, but in unit B, it increased from 6 to 8 days. Logistic regression analysis confirmed a significant reduction in mortality in unit A (odds ratio (OR) 0.50; 95% confidence interval (CI) 0.29-0.86). The study found a positive correlation between adherence to telemedicine recommendations and mortality reduction across both units. This suggests that telemedicine can effectively improve outcomes in PICUs, particularly in regions with limited health-care resources. Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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