远程医疗治疗非急性头痛的可接受性、可行性和成本:卡塔尔世界杯8强波胆分析视频会诊与传统会诊的随机对照研究%A maller,Kai Ivar %A Alstadhaug,Karl Bjørnar %A Bekkelund,Svein Ivar %+北挪威大学医院神经内科，Sykehusvegen 38, N-9038，挪威特罗姆瑟，47 77627073,kai.ivar.muller@unn.no %K头痛%K管理%K会诊%K远程医疗%K负担%K成本%K可行性%K农村%K随机化%D 2016 %7 30.05.2016 %9原文%J J Med Internet Res %G English %X远程医疗在诊断和治疗非急性头痛(如原发性头痛(偏头痛和紧张性头痛)和药物过度使用头痛)方面的可行性此前尚未进行研究。由于不需要去找专家，远程医疗可以节省大量的时间和金钱。目的:我们的目的是评估远程医疗的接受程度，并调查远程医疗会诊在诊断和治疗非急性头痛方面的可行性和成本节约。方法:对2012年9月至2015年3月通过电子申请系统转诊的挪威北部非急性头痛患者进行连续筛选，随机分为远程医疗和传统专科就诊两组。所有患者均由特罗姆瑟大学医院神经内科的两名神经科医生进行咨询。比较远程医疗与传统医疗组的可行性结果。然后比较农村和城市患者的基线特征和费用。旅行费用是通过使用挪威旅行社的概率方法计算的:每个研究参与者最便宜的公共交通工具。 Loss of pay was calculated based on the Norwegian full-time employee’s average salary: < 3.5 hours=a half day’s salary, > 3.5 hours spent on travel and consultation=one day’s salary. Distance and time spent on travel were estimated by using Google Maps. Results: Of 557 headache patients screened, 479 were found eligible and 402 accepted telemedicine participation (83.9%, 402/479) and were included in the final analyses. Of these, 202 received traditional specialist consultations and 200 received telemedicine. All patients in the telemedicine group were satisfied with the video quality, and 198 (99%, 198/200) were satisfied with the sound quality. The baseline characteristics as well as headache diagnostics and follow-up appointments, and the investigation, advice, and prescription practices were not statistically different between the two randomized groups. In addition, telemedicine consultations were shorter than traditional visits (38.8 vs 43.7 min, P<.001). The travel cost per rural individual (292/402, 73%) was €249, and estimated lost income was €234 per visit. The travel cost in the urban area (110/402, 27%) was €6, and estimated lost income was €117 per visit. The median traveling distance for rural patients was 526 km (range 1892 km), and the median traveling time was 7.8 hours (range 27.3 hours). Rural patients had a longer waiting time than urban patients (64 vs 47 days, P=.001), and fewer women were referred from rural areas (P=.04). Rural women reported higher pain scores than urban women (P=.005). Conclusion: Our study shows that telemedicine is an accepted, feasible, time-saving, and cost-saving alternative to traditional specialist consultations for nonacute headaches. Trial Registration: Clinicaltrials.gov NCT02270177; http://clinicaltrials.gov/ct2/show/NCT02270177 (Archived by WebCite at http://www.webcitation.org/6hmoHGo9Q) %M 27241876 %R 10.2196/jmir.5221 %U //www.mybigtv.com/2016/5/e140/ %U https://doi.org/10.2196/jmir.5221 %U http://www.ncbi.nlm.nih.gov/pubmed/27241876