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. 2021 Mar;27(3):286-295.
doi: 10.1089/tmj.2020.0075. Epub 2020 Sep 9.

A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast

Florent Kouakou Diby  1 , Anicet Kassi Adoubi  1 , Marie-Clémence Aya Esse-Diby  2 , Ambroise Loa Gnaba  1 , Serge Zadi Zadi  3 , Adjara Evelyne Pinnin Ouattara  1 , Kouassi Efrahime N'Guessan  4 , Kouakou Boidy  5 , Richard Azagoh-Kouadio  6 , Innocent Nanan  7 , Mamadou Doumbia  7 , Roger Kpon  7   8 , Kouakou Grégoire Ayegnon  1 , Christophe Gueu Meneas  1 , Manga Diomande  1 , Fatouma Sall  1 , Marie-Nina Koffi  1 , Abdoulaye Coulibaly  1 , Elisé Appiah Ehui  9 , Koffi Mathieu Yao  9 , Jean Modeste Yapo  9 , Somian Francis Ehua  7 , Hervé Koffi Yangni-Angate  1 , Pierre Simon  10 , Thierry Moulin  10   11
Affiliations

A Medico-Socio-Economic Analysis of TeleEKG in Ivory Coast

Florent Kouakou Diby et al. Telemed J E Health. 2021 Mar.

Abstract

Background:TeleEKG is gradually being integrated into the care offered to the most isolated Ivorian populations, however, no medico-socio-economic analysis of its impact has yet been conducted.Introduction:The aim of this study was to assess the medico-socio-economic impact of a teleEKG network in the provision of cardiology care in Ivory Coast.Methods:A retrospective study of the data transmitted by the 10 centers involved in the pilot phase of the teleEKG project from January 2015 to December 2017.Results:The average ratio between the cost to the patient of performing an electrocardiogram (EKG) according to the traditional practice and using a teleEKG was 3.8 ± 1.64. The distance avoided by the 6,045 patients was 1,074,090 km (average 177.7 km/patient). The 6,045 teleEKGs carried out over the period of the study produced a total revenue of 36,270,000 XOF (55,290 EUR) or an average revenue per site of 3,627,000 XOF (5,529 EUR). Dyspnea on exertion (22%), and hypertension (21%) were the main indications for performing the EKG, and left ventricular hypertrophy was the most common electrical anomaly detected (19.8%). Acute coronary syndrome with persistent ST segment elevation was diagnosed in 0.7% of cases (40 cases) and atrial fibrillation in 1.12% of cases (68 cases).Discussion:These results confirm the key role telemedicine can play in the treatment of heart conditions in rural populations and the economic sustainability of such telemedicine networks.Conclusions:teleEKG offers economic accessibility to cardiology care for isolated populations in Ivory Coast.

Keywords: ACS; HBP; atrial fibrillation; teleEKG; telemedicine.

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