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Arch Pathol Lab Med ; 144(11): 1381-1391, 2020 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33106859

RESUMEN

CONTEXT.­: Since 2008, the Northern Territory Point-of-Care Testing Program has improved patient access to pathology testing for acute and chronic disease management for remote health services. OBJECTIVE.­: To evaluate the analytical quality, service delivery, and clinical utility of an expanding remote point-of-care testing network. DESIGN.­: Four years (2016-2019) of data on analytical quality, test numbers, and training statistics and 6 months of clinical point-of-care testing data from Abbott i-STATs at remote health services throughout the Northern Territory were analyzed to assess analytical performance, program growth, and clinical utility. RESULTS.­: From 2016 to 2019, point-of-care test numbers increased, with chemistry and blood gas testing more than doubling to 8500 and 6000 tests, respectively, troponin I testing almost doubling (to 6000), and international normalized ratio testing plateauing at 8000 tests. Participation in quality control and proficiency testing was high, with quality comparable to laboratory-based analytical goals. A shift toward flexible training and communication modes was noted. An audit of point-of-care test results demonstrated elevated creatinine, associated with chronic kidney disease management, as the most common clinically actionable patient result. CONCLUSIONS.­: The Northern Territory Point-of-Care Testing Program provides high quality point-of-care testing within remote primary health services for acute and chronic patient management and care. Clinical need, sound analytical performance, flexibility in training provision, and effective support services have facilitated the sustainability of this expanding point-of-care testing model in the remote Northern Territory during the past 11 years.


Asunto(s)
Accesibilidad a los Servicios de Salud/normas , Servicios de Salud del Indígena/normas , Sistemas de Atención de Punto , Pruebas en el Punto de Atención/normas , Atención Primaria de Salud/normas , Calidad de la Atención de Salud/normas , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Diabetes Mellitus/prevención & control , Geografía , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Servicios de Salud del Indígena/estadística & datos numéricos , Humanos , Enfermedades Renales/diagnóstico , Enfermedades Renales/epidemiología , Enfermedades Renales/prevención & control , Northern Territory/epidemiología , Aceptación de la Atención de Salud/estadística & datos numéricos , Pruebas en el Punto de Atención/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Calidad de la Atención de Salud/estadística & datos numéricos , Enfermedades Respiratorias/diagnóstico , Enfermedades Respiratorias/epidemiología , Enfermedades Respiratorias/prevención & control
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