AimThe purpose of this study is to explore the effectiveness of a hospital-based asynchronous ear, nose, and throat (ENT) telehealth service (the Ear Portal) in reducing cost and improving access for children with otitis media.MethodsParticipants were recruited to the Ear Portal from a tertiary hospital ENT waiting list. Ear and hearing assessments were conducted during appointments by the Ear Portal research assistant, and data was stored for an asynchronous review by the Ear Portal multidisciplinary team. A cost-minimisation analysis was conducted for the Ear Portal and the standard care pathways. Waiting times to provide care for both pathways were calculated for children with semi-urgent (i.e. Category 2) and non-urgent (i.e. Category 3) referrals.ResultsThe running cost for the Ear Portal was $67.70 for initial appointments and $37.34 for follow-up appointments. Conversely, the running cost for the standard care pathway was $154.65 for initial appointments and $86.10 for follow-up appointments. A total of 223 appointments were required to offset the initial Ear Portal investment of $19,384.00. The median waiting time for the Ear Portal from initial contact to care plan delivery was <30 days, whereas the median waiting times for children in the standard care pathway were 291 days (interquartile range (IQR) = 117) for Category 2 and 371 days (IQR = 311) for Category 3 referrals.ConclusionUnder the current circumstances, the Ear Portal service can reduce costs for the health care system by reducing marginal costs per patient in addition to providing ENT specialist care within the clinically recommended timeframes.

中文翻译：

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为中耳炎儿童提供基于医院的异步耳鼻喉科远程医疗服务：成本最小化和改善获取

目的本研究的目的是探讨基于医院的异步耳鼻喉 (ENT) 远程医疗服务（耳朵门户）在降低成本和改善中耳炎儿童的获取机会方面的有效性。方法参与者被招募到耳朵来自三级医院耳鼻喉科等候名单的门户网站。耳朵和听力评估是在 Ear Portal 研究助理预约期间进行的，并且存储数据以供 Ear Portal 多学科团队异步审查。对耳入口和标准护理途径进行了成本最小化分析。针对半紧急（即第 2 类）和非紧急（即第 3 类）转诊的儿童计算了为这两种途径提供护理的等待时间。结果 耳入口的运行成本为初次预约 67.70 美元，后续预约 37.34 美元约会。相反，标准护理途径的初始预约运行成本为 154.65 美元，后续预约运行成本为 86.10 美元。总共需要 223 次预约才能抵消 Ear Portal 的初始投资 19,384.00 美元。从初次接触到护理计划交付的耳入口等待时间中位不到 30 天，而标准护理路径中儿童的中位等待时间为 291 天（四分位距 (IQR) = 117），类别 2 为 371 天(IQR = 311) 对于第 3 类转诊。结论在当前情况下，Ear Portal 服务除了在临床建议的时间范围内提供耳鼻喉专科护理之外，还可以通过降低每位患者的边际成本来降低医疗保健系统的成本。