چکیده (انگلیسی):

Background:Teleradiology entails attainment of x-rays in one location, transfer over some distance and assessment at
another location for diagnosis or consultation. This study documents fracture diagnostics, unnecessary trips to the
hospital, treatment and number of x-rays for the years 2006 and 2009, before and after the introduction of teleradiology
in a general practice on the island of Ameland in the north of the Netherlands.
Methods:In a retrospective, descriptive, observational before and after study of the introduction of x-ray facilities in an
island-based general practice, we compared the number of accurately diagnosed fractures, unnecessary trips, treatments
and number of x-rays taken in 2006 when only a hospital x-ray facility was available 5 hours away with those in 2009 after
an x-ray facility became available at a local general practice. All patients visiting a general practice on the island of
Ameland in 2006 and 2009 with traumaandclinical suspicion of a fracture, dislocation or sprain were included in the
study. The initial clinical diagnoses, including those based on the outcomes of x-rays, were compared for the two years
and also whether the patients were treated at home or in hospital.
Results:A total of 316 and 490 patients with trauma visited a general practice in 2006 and 2009, respectively. Of these
patients, 66 and 116 were found to have fractures or dislocations in the two years, respectively. In 2006, 83 x-rays were
ordered; in 2009, this was 284. In 2006, 9 fractures were missed;in 2009, this was only 2. In 2006, 15 patients with fractures
or dislocations were treated at the general practice; in 2009, this had increased to 77.
Conclusion:Since the introduction of teleradiology the numberof missed fractures in patients visiting the general
practice with trauma and the number of the unnecessary trips to a hospital are reduced. In addition more patients with
fractures and dislocations can be treated in the general practice as opposed to the hospital.