title: Availability, spatial accessibility, utilisation and the role of telehealth for multi-disciplinary paediatric cerebral palsy services in Queensland.
abstract: OBJECTIVE
  The purpose of this study was to understand the methods of current delivery of health care services to cerebral palsy (CP) patients in Queensland, Australia. The study also examines the current use of telehealth by clinicians and their perceptions about telehealth use.
  
  
  METHODS
  Patient records during July 2013-July 2014 were accessed from the Queensland Paediatric Rehabilitation Service (QPRS) to collect information relating to the service delivery for CP patients. Analysis was carried out to examine the patient locations and travel distances using ArcMap geoprocessing software. In addition, 13 face-to-face semi structured interviews were conducted with clinicians from the QPRS and the Cerebral Palsy Health Service (CPHS) to understand the perceptions of clinicians relating to the current level of health care delivery. We also examined the clinicians' current use of telehealth and their opinions about this method.
  
  
  RESULTS
  Records of 329 paediatric CP patients were accessed and reviewed. The majority of patients (96%, n = 307) who attended the clinics at the Royal Children's Hospital (RCH), Brisbane, were from remote, rural or regional areas of Queensland. Only 4% of patients (n = 13) were from major cities. During 12 months, patients had attended nine outreach programmes that were conducted by the QPRS and CPHS. The study found that non-local patients were required to travel an average distance of 836 km to access QPRS and CPHS services in Brisbane. The average distance for receiving a consultation at an outreach clinic was 173 km. Clinicians perceived that access to health care services to CP patients in Queensland is inadequate. Nearly all clinicians interviewed had some experience in using telehealth. They had high satisfaction levels with the method.
  
  
  CONCLUSIONS
  Traditional methods of delivering services to CP patients do not meet their needs. Clinicians have found telehealth is a feasible and satisfactory delivery method. However, the use of telehealth is still limited.
authors.affiliation: Centre for Online Health, The University of Queensland, Australia s.edirippulige@uq.edu.au.
authors.forename: Sisira
authors.initials: S
authors.lastname: Edirippulige
authors.affiliation: Centre for Online Health, The University of Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Reyno
authors.affiliation: Centre for Online Health, The University of Queensland, Australia Centre for Children's Health Research, Australia.
authors.forename: Nigel R
authors.initials: NR
authors.lastname: Armfield
authors.affiliation: School of Medicine, The University of Queensland, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bambling
authors.affiliation: Lady Cilento Children's Hospital, Australia.
authors.forename: Owen
authors.initials: O
authors.lastname: Lloyd
authors.affiliation: Lady Cilento Children's Hospital, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: McNevin
mesh_terms: D001291:Attitude of Health Personnel; D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration; D011793:Queensland; D019035:Rural Health Services / Q000458:organization & administration / Q000706:statistics & numerical data / Q000600:supply & distribution; D017216:Telemedicine / Q000379:methods / Q000458:organization & administration / Q000706:statistics & numerical data
keywords: Queensland; Rehabilitation; cerebral palsy; paediatric medicine; rural; telehealth