Using videotelephony to support paediatric oncology-related palliative care in the home: from abandoned RCT to acceptability study
Child; Female; Humans; Male; Palliative Care; Adult; Patient Acceptance of Health Care; Australia; Computer Security; Continuity of Patient Care; Cost-Benefit Analysis; Early Termination of Clinical Trials; Patient Satisfaction; PPC Book Chapter 2011 (Kim Widger); adolescent; Preschool; Parents/psychology; Neoplasms/therapy; Computer Communication Networks/economics; Health Services Accessibility/economics; Home Care Services/economics; Rural Health Services/economics; Telemedicine/economics/instrumentation/methods; Videoconferencing/economics/instrumentation
Videotelephony (real-time audio-visual communication) has been used successfully in adult palliative home care. This paper describes two attempts to complete an RCT (both of which were abandoned following difficulties with family recruitment), designed to investigate the use of videotelephony with families receiving palliative care from a tertiary paediatric oncology service in Brisbane, Australia. To investigate whether providing videotelephone-based support was acceptable to these families, a 12-month non-randomised acceptability trial was completed. Seventeen palliative care families were offered access to a videotelephone support service in addition to the 24 hours 'on-call' service already offered. A 92% participation rate in this study provided some reassurance that the use of videotelephones themselves was not a factor in poor RCT participation rates. The next phase of research is to investigate the integration of videotelephone-based support from the time of diagnosis, through outpatient care and support, and for palliative care rather than for palliative care in isolation. Trial registration ACTRN 12606000311550.
2009
Bensink ME; Armfield NR; Pinkerton R; Irving H; Hallahan A; Theodoros DG; Russell T; Barnett AG; Scuffham P; Wootton R
Palliative Medicine
2009
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1177/0269216308100251" target="_blank" rel="noreferrer">10.1177/0269216308100251</a>
The costs and potential savings of a novel telepaediatric service in Queensland
Child; Humans; Hospitals; Cost of Illness; Health Care Costs; Queensland; Cost Savings; Outpatient Clinics; Referral and Consultation/economics; Health Services Accessibility/economics; Hospital/economics/utilization; Pediatric/economics; Pediatrics/economics/methods; Remote Consultation/economics/instrumentation/utilization; Transportation/economics; Videoconferencing/economics/instrumentation/utilization
BACKGROUND: There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person. METHODS: In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialties including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry. RESULTS: During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was 1,553,264 Australian dollars; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider. CONCLUSION: Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.
2007
Smith AC; Scuffham P; Wootton R
Bmc Health Services Research
2007
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1186/1472-6963-7-35" target="_blank" rel="noreferrer">10.1186/1472-6963-7-35</a>
Investigating the cost-effectiveness of videotelephone based support for newly diagnosed paediatric oncology patients and their families: design of a randomised controlled trial
Child; Humans; Adult; Parent-Child Relations; Research Design; Australia; Cost-Benefit Analysis; Patient Satisfaction; Cost of Illness; Oncology Service; quality of life; adolescent; Preschool; Study Design; Randomized Controlled Trials/methods; Health Services Accessibility/economics; Rural Health Services/economics; Ambulatory Care/economics; Child Health Services/economics; Hospital/economics; Neoplasms/economics/therapy; Telemedicine/economics/instrumentation; Videoconferencing/economics
BACKGROUND: Providing ongoing family centred support is an integral part of childhood cancer care. For families living in regional and remote areas, opportunities to receive specialist support are limited by the availability of health care professionals and accessibility, which is often reduced due to distance, time, cost and transport. The primary aim of this work is to investigate the cost-effectiveness of videotelephony to support regional and remote families returning home for the first time with a child newly diagnosed with cancer METHODS/DESIGN: We will recruit 162 paediatric oncology patients and their families to a single centre randomised controlled trial. Patients from regional and remote areas, classified by Accessibility/Remoteness Index of Australia (ARIA+) greater than 0.2, will be randomised to a videotelephone support intervention or a usual support control group. Metropolitan families (ARIA+ < or = 0.2) will be recruited as an additional usual support control group. Families allocated to the videotelephone support intervention will have access to usual support plus education, communication, counselling and monitoring with specialist multidisciplinary team members via a videotelephone service for a 12-week period following first discharge home. Families in the usual support control group will receive standard care i.e., specialist multidisciplinary team members provide support either face-to-face during inpatient stays, outpatient clinic visits or home visits, or via telephone for families who live far away from the hospital. The primary outcome measure is parental health related quality of life as measured using the Medical Outcome Survey (MOS) Short Form SF-12 measured at baseline, 4 weeks, 8 weeks and 12 weeks. The secondary outcome measures are: parental informational and emotional support; parental perceived stress, parent reported patient quality of life and parent reported sibling quality of life, parental satisfaction with care, cost of providing improved support, health care utilisation and financial burden for families. DISCUSSION: This investigation will establish the feasibility, acceptability and cost-effectiveness of using videotelephony to improve the clinical and psychosocial support provided to regional and remote paediatric oncology patients and their families.
2007
Bensink M; Wootton R; Irving H; Hallahan A; Theodoros D; Russell T; Scuffham P; Barnett AG
Bmc Health Services Research
2007
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1186/1472-6963-7-38" target="_blank" rel="noreferrer">10.1186/1472-6963-7-38</a>