ABSTRACT
We evaluated user satisfaction with a PC-based videoconferencing system used for child psychiatry assessments and performed a cost analysis. Thirty patients (aged 5-16 years), accompanied by a parent, completed a psychiatric assessment using the videoconferencing system. One of five child psychiatrists was randomly assigned to each assessment. Satisfaction questionnaires were completed after each assessment by the psychiatrist, patient and parent. Parents also completed a cost questionnaire. The telecommunications bandwidth was 336 kbit/s. The psychiatrists stated that they were either 'very satisfied' or 'satisfied' with the telepsychiatry assessments. On a five-point Likert scale (1 = lowest, 5 = highest), 28 of the 30 parents (93%) rated their satisfaction level as 5; the other two rated it 4. All 30 parents (100%) stated that they 'liked' the telepsychiatry assessment and would use the system again. Twenty-nine parents (97%) indicated that they would prefer to use the telepsychiatry system to travelling to see a child psychiatrist in person. Eleven children (aged 5-12) participated and all (100%) said they 'liked' using the telepsychiatry system. Five out of nine children (56%) stated they liked the 'television doctor' better than the 'real' doctor; four said they had no preference. Nineteen adolescents (aged 13-16 years) participated and most were very satisfied or satisfied with the system. Seventeen of the 19 adolescents (89%) said they would prefer to see the psychiatrist on the videoconferencing system to travelling for an assessment, and the same number said that they would use telepsychiatry again. The estimated total travel cost for the 30 patients was $12,849, an average of $428 per patient. The total cost of the telepsychiatry service for the three-month pilot was $12,575, or $419 per patient.
Subject(s)
Consumer Behavior , Mental Disorders/diagnosis , Remote Consultation/standards , Adolescent , Attitude to Computers , Child , Child, Preschool , Cost of Illness , Cost-Benefit Analysis , Female , Health Care Costs , Health Services Accessibility , Humans , Male , Mental Disorders/economics , Mental Disorders/psychology , Parents/psychology , Remote Consultation/economics , Time FactorsABSTRACT
1. Chicken pancreas has been shown to synthesize and secrete uric acid. Uric acid synthesis from xanthine in vitro by isolated pancreatic acinii is saturable and dependent on the activity of xanthine dehydrogenase. 2. Chicken pancreas is unable to synthesize uric acid de novo but the variety of substrates which support urate synthesis suggests that it occurs by the purine degradation pathway.
