Abstract：
OBJECTIVE: This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non-Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia.
METHODS: Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020.
RESULTS: Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non-Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status - (non-Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy.
CONCLUSIONS: This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.
METHODS: Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020.
RESULTS: Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non-Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status - (non-Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy.
CONCLUSIONS: This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.
摘要：
目的：这项研究调查了居住在澳大利亚北领地（NT）偏远和地区社区的土著和非土著儿童睡眠健康评估的远程健康模型的结果。
方法：视频远程健康咨询，包括临床病史和由州际儿科睡眠医生虚拟评估的相关体格检查结果是远程进行的.在达尔文当地进行了多导睡眠图（PSG）和治疗干预，NT.研究参与者是2015年至2020年期间转诊的儿童。
结果：在接受睡眠评估的812名儿童中，699接受了诊断性PSG。大多数患者是女性（63%）。非土著(81%)，居住在外部区域(88%)。土著儿童年龄明显较大，居住在偏远或非常偏远的地方(22%与10%)。转诊模式因地区和土著身份而异-(非土著通过私人(53%)，通过公共系统土著(35%))。从咨询到PSG，转诊到初次咨询的中位数为16天和4周。远程儿童在转诊和初次咨询之间的时间延迟稍长(32vs.15天）。51%被诊断患有OSA,27%接受了腺样体扁桃体切除术，2%接受了CPAP治疗。
结论：这项研究表明，远程健康模式可以有效地克服后勤障碍，并为偏远和地区的澳大利亚儿童提供睡眠健康服务。需要进一步的创新努力来改善服务模式，扩大非常偏远社区的弱势儿童的覆盖面。
方法：视频远程健康咨询，包括临床病史和由州际儿科睡眠医生虚拟评估的相关体格检查结果是远程进行的.在达尔文当地进行了多导睡眠图（PSG）和治疗干预，NT.研究参与者是2015年至2020年期间转诊的儿童。
结果：在接受睡眠评估的812名儿童中，699接受了诊断性PSG。大多数患者是女性（63%）。非土著(81%)，居住在外部区域(88%)。土著儿童年龄明显较大，居住在偏远或非常偏远的地方(22%与10%)。转诊模式因地区和土著身份而异-(非土著通过私人(53%)，通过公共系统土著(35%))。从咨询到PSG，转诊到初次咨询的中位数为16天和4周。远程儿童在转诊和初次咨询之间的时间延迟稍长(32vs.15天）。51%被诊断患有OSA,27%接受了腺样体扁桃体切除术，2%接受了CPAP治疗。
结论：这项研究表明，远程健康模式可以有效地克服后勤障碍，并为偏远和地区的澳大利亚儿童提供睡眠健康服务。需要进一步的创新努力来改善服务模式，扩大非常偏远社区的弱势儿童的覆盖面。
