Custo-benefício do serviço de telecardiologia no Estado de Minas Gerais: projeto Minas Telecardio

Andrade, Mônica Viégas; Maia, Ana Carolina; Cardoso, Clareci Silva; Alkmim, Maria Beatriz Moreira; Ribeiro, Antônio Luiz Pinho

doi:10.1590/s0066-782x2011005000080

Cited by 54 publications

(16 citation statements)

References 11 publications

(12 reference statements)

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“…The network was established in 2005 to connect hospitals from 5 public universities in the state. Since then, it has been successfully delivering health care to remote and underserved areas, providing cost‐effective36 services (teleelectrocardiography, teleconsultations,19 diabetes mellitus care,37 and support to systems of care) that give support to primary care through a network of experts. RHD programs can benefit from the existing infrastructure, political support, community involvement, and adaptation to local work routines for integration with primary care 19.…”

Section: Discussionmentioning

confidence: 99%

Comparison Between Different Strategies of Rheumatic Heart Disease Echocardiographic Screening in Brazil: Data From the PROVAR (Rheumatic Valve Disease Screening Program) Study

Nascimento

Sable

Nunes

et al. 2018

JAHA

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BackgroundConsidering the limited accuracy of clinical examination for early diagnosis of rheumatic heart disease (RHD), echocardiography has emerged as an important epidemiological tool. The ideal setting for screening is yet to be defined. We aimed to evaluate the prevalence and pattern of latent RHD in schoolchildren (aged 5–18 years) and to compare effectiveness of screening between public schools, private schools, and primary care centers in Minas Gerais, Brazil.Methods and ResultsThe PROVAR (Rheumatic Valve Disease Screening Program) study uses nonexperts and portable and handheld devices for RHD echocardiographic screening, with remote interpretation by telemedicine, according to the 2012 World Heart Federation criteria. Compliance with study consent and prevalence were compared between different screening settings, and variables associated with RHD were analyzed. In 26 months, 12 048 students were screened in 52 public schools (n=10 901), 2 private schools (n=589), and 3 primary care centers (n=558). Median age was 12.9 years, and 55.4% were girls. Overall RHD prevalence was 4.0% borderline (n=486) and 0.5% definite (n=63), with statistically similar rates between public schools (4.6%), private schools (3.5%), and primary care centers (4.8%) (P=0.24). The percentage of informed consents signed was higher in primary care centers (84.4%) and private schools (66.9%) compared with public schools (38.7%) (P<0.001). Prevalence was higher in children ≥12 years (5.3% versus 3.1%; P<0.001) and girls (4.9% versus 4.0%; P=0.02). Only age (odds ratio, 1.12; 95% confidence interval, 1.09–1.17; P<0.001) was independently associated with RHD.Conclusions RHD screening in primary care centers seems to achieve higher coverage rates. Prevalence among schoolchildren is significantly high, with rates higher than expected in private schools of high‐income areas. These data are important for the formulation of public policies to confront RHD.

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Section: Discussionmentioning

confidence: 99%

Comparison Between Different Strategies of Rheumatic Heart Disease Echocardiographic Screening in Brazil: Data From the PROVAR (Rheumatic Valve Disease Screening Program) Study

Nascimento

Sable

Nunes

et al. 2018

JAHA

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“…There are benefits such as reducing the number of referrals and identifying patients who need urgent care. 1,3,4 This service is fully integrated into the health system of all municipalities and is very successful, having performed over 1,700,000 ECG reports, which currently corresponds to an average of 1,700 exams per day. Given the large number of tests performed, the analysis of ECGs can allow the knowledge of the proportion of normal and abnormal ECGs in primary care patients.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of normal electrocardiograms in primary care patients

Marcolino

Palhares

Alkmim

et al. 2014

Rev. Assoc. Med. Bras.

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Objective: Knowing the proportion the proportion of normal and abnormal electrocardiograms (ECGs) in primary care patients allows us to estimate the proportion of exams that can be analyzed by the general practitioner with minimal training in ECG interpretation, in addition to being epidemiologically relevant. The objective of this study is to assess the prevalence of normal ECGs in primary care patients. Methods: all digital ECGs analyzed by the cardiologists of Telehealth Network of Minas Gerais (TNMG) in 2011 were evaluated. TNMG is a public telehealth service that provides support to primary care professionals in 662 municipalities in the state of Minas Gerais, Brazil. Results: during the study period, 290,795 ECGs were analyzed (mean age 51 ± 19 years), 57.6% were normal. This proportion was higher in women (60.1 vs 57.6%, p <0.001) and lower in patients with hypertension (45.8% vs 63.2%, p <0.001) or diabetes (43.3% vs 63.2%, p <0.001). A progressive reduction in the prevalence of normal ECG with increasing age was observed. Among the ECGs of patients under investigation for chest pain, 58.7% showed no abnormalities. Conclusion: the prevalence of normal ECGs in primary care patients is higher than 50% and this proportion decreases with age and comorbidities. Most ECGs performed for investigation of chest pain in primary care shows no abnormality.Uniterms: electrocardiography, telemedicine, primary health care.

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“…the use of the internet to send electrocardiograms [EKGs] from remote areas to university hospitals for interpretation). The project proved feasible and financially sound [6][7][8] and satisfaction among physicians working in remote locations increased markedly. 9,10 After 2007, the Telehealth Network of Minas Gerais began providing teleconsultations also.…”

mentioning

confidence: 99%

Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil

Alkmim

Figueira

Marcolino

et al. 2012

Bull World Health Org

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151

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Custo-benefício do serviço de telecardiologia no Estado de Minas Gerais: projeto Minas Telecardio

Abstract: Background: Telecardiology is a tool that can aid in cardiovascular care, mainly in towns located in remote areas. However, economic assessments on this subject are scarce and have yielded controversial results.

Cited by 54 publications

References 11 publications

Comparison Between Different Strategies of Rheumatic Heart Disease Echocardiographic Screening in Brazil: Data From the PROVAR (Rheumatic Valve Disease Screening Program) Study

Comparison Between Different Strategies of Rheumatic Heart Disease Echocardiographic Screening in Brazil: Data From the PROVAR (Rheumatic Valve Disease Screening Program) Study

Prevalence of normal electrocardiograms in primary care patients

Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil

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