Backround There is a shortage of medical specialists in Chile, including neurologists; currently, there are 56,614 patients waiting for a first adult Neurology appointment in the country. The Teleneurology Program at the Hospital Las Higueras de Talcahuano (HHT) was implemented in 2015 to help reduce both the number of patients waiting for a first consultation and their waiting times. METHODS This retrospective study analyzed a cohort of 8269 patients referred to the HHT Neurology clinic between 2013 and 2018, from primary, secondary, and tertiary health centers. Cox regression analyses were performed to determine the factors influencing each outcome (number of patients waiting for a consultation and waiting time), such as age, gender, referral health establishment and the type of consultation (whether in situ at the HHT or by synchronic telepresence through the Teleneurology Program). RESULTS Out of the 8269 patients included in the study, 1743 consulted the neurologist through the Teleneurology Program, while 6526 received a consultation in situ at the HHT. Since its implementation (2015) until the end of 2018, the Teleneurology program contributed to decrease the number of patients waiting for their first appointment from 3084 to 298. Waiting time for the first consultation was 60% shorter for patients enrolled in the Teleneurology program than those with consultation in situ at HHT (6.23 ± 6.82 and 10.47 ± 8.70 months, respectively). Similar differences were observed when sorting patient data according to the referral health center. Cox regression analysis showed that patients waiting for a traditional in situ first adult Neurology consultation at the HHT had a higher risk (OR = 6.74) of waiting 90% longer than patients enrolled in the Teleneurology Program, without significant differences due to gender or age. CONCLUSIONS Data from this study show a significant contribution of the Teleneurology Program at the HHT to decrease the number of patients waiting for a first consultation with a neurologist, as well as shorter waiting times, when derived from primary and secondary health centers.

中文翻译：

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同步远程神经病学计划的贡献，以减少等待首次咨询的患者人数及其在智利的等待时间。

背景技术在智利，包括神经科医生在内的医学专家短缺。目前，该国有56,614位患者在等待首次成人神经科预约。拉斯Higueras de Talcahuano医院（HHT）的远程神经病学计划于2015年实施，以帮助减少等待初诊的患者人数和等待时间。方法这项回顾性研究分析了2013年至2018年间从一级，二级和三级健康中心转诊至HHT神经病学诊所的8269例患者。进行了Cox回归分析，以确定影响每个结局（等待咨询的患者数量和等待时间）的因素，例如年龄，性别，转诊医疗机构和咨询类型（无论是在HHT现场还是通过远程神经网络计划进行远程呈现）。结果在纳入研究的8269例患者中，有1743例通过Teleneurology计划向神经科医生咨询，而6526例在HHT接受了现场咨询。自从实施（2015年）到2018年底，远程神经病学计划将等待首次预约的患者人数从3084减少到298。参加远程神经病学计划的患者首次咨询的等待时间比缩短了60％在HHT就诊的患者（分别为6.23±6.82和10.47±8.70个月）。根据转诊健康中心对患者数据进行排序时，观察到类似的差异。Cox回归分析表明，与参加远程神经病学计划的患者相比，在HHT等待传统的就地初次成人神经内科咨询的患者比在远程神经病学计划中接受治疗的患者有90％的更高风险（OR = 6.74）等待，而没有性别或年龄的显着差异。结论该研究的数据表明，在HHT进行的远程神经病学计划对减少从一级和二级卫生中心获得的神经科医师初诊的患者数量以及缩短的等待时间做出了重大贡献。