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[巴西米纳斯吉拉斯州偏远市镇初级卫生保健的远程医疗支持]

[Telehealth support for primary health care in remote municipalities in the state of Minas Gerais, Brazil].

作者信息

Marcolino Milena Soriano, Alkmim Maria Beatriz, Assis Tati Guerra Pezzini, Sousa Lidiane Aparecida Pereira de, Ribeiro Antonio Luiz Pinho

机构信息

Faculdade de Medicina e Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Rede de Teleassistência de Minas Gerais, Belo Horizonte, MG, Brasil.

出版信息

Rev Panam Salud Publica. 2014 May-Jun;35(5-6):345-52.

Abstract

OBJECTIVE

To analyze the use, effectiveness, and resolubility of teleconsultation services provided to primary care units by the Telehealth Network of Minas Gerais, a public service providing teleconsultation and telediagnosis in cardiology to 821 health care sites.

METHODS

This observational retrospective study included teleconsultations carried out between April 2007 and December 2012. Teleconsultations performed from January to May 2010 and January to March 2012 were analyzed regarding the type of query asked by professionals using the service. A survey was carried out to evaluate resolubility and level of satisfaction with teleconsultations.

RESULTS

During the study period, 47 689 teleconsultations were carried out. They were most often requested by nurses (53.2%) and physicians (34.3%), and were answered mainly by the following professionals: family physicians (23.3%), dermatologists (19.8%), gynecologists (10,7%), internal medicine physicians (8.8%), pediatricians (6.6%), and nurses (12.2%). The median population in the municipalities that requested teleconsultations was 6 778 (interquartile range [IQR]: 4 425 - 10 805). The median human development index (HDI) was 0.645 (IQR: 0.577 - 0.690). The most frequent queries regarded pharmacological treatment, non-pharmacological treatment, and etiology. Teleconsultations prevented potential referrals in 80% of the cases, and 94% of the health providers reported satisfaction with the service.

CONCLUSIONS

The results show that the Telehealth Network of Minas Gerais can help overcome physical barriers in the access to health care and that it may be an important and effective tool for continued health education.

摘要

目的

分析米纳斯吉拉斯远程医疗网络向基层医疗单位提供的远程会诊服务的使用情况、有效性和可解决性。该公共服务为821个医疗点提供心脏病学方面的远程会诊和远程诊断。

方法

这项观察性回顾性研究纳入了2007年4月至2012年12月期间进行的远程会诊。对2010年1月至5月以及2012年1月至3月进行的远程会诊,分析了使用该服务的专业人员提出的询问类型。开展了一项调查以评估远程会诊的可解决性和满意度。

结果

在研究期间,共进行了47689次远程会诊。会诊请求大多由护士(53.2%)和医生(34.3%)提出,主要由以下专业人员回复:家庭医生(23.3%)、皮肤科医生(19.8%)、妇科医生(10.7%)、内科医生(8.8%)、儿科医生(6.6%)和护士(12.2%)。请求远程会诊的市的人口中位数为6778(四分位间距[IQR]:4425 - 10805)。人类发展指数(HDI)中位数为0.645(IQR:0.577 - 0.690)。最常见的询问涉及药物治疗、非药物治疗和病因。远程会诊在80%的病例中避免了潜在的转诊,94%的医疗服务提供者对该服务表示满意。

结论

结果表明,米纳斯吉拉斯远程医疗网络有助于克服获得医疗服务方面的物理障碍,并且可能是持续健康教育的重要且有效工具。

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