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基层医疗中的电话咨询。

Telephone consultation in primary care.

作者信息

Gonzalez Francisco, Cimadevila Blanca, Garcia-Comesaña Julio, Cerqueiro Susana, Andion Eladio, Prado Jorge, Bermudez Jorge, Rubial Felix

机构信息

Service of Ophthalmology, Complejo Hospitalario, Universitario of Santiago de Compostela, Santiago de Compostela, Spain.

Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

出版信息

J Health Organ Manag. 2018 Apr 9;32(2):321-337. doi: 10.1108/JHOM-08-2017-0201. Epub 2018 Mar 26.

Abstract

Purpose The purpose of this paper is to describe and analyze a teleconsultation modality based on a simple telephone call, using either landline or mobile phone, made available to more than two million people. Telecommunication systems are an increasingly common feature in modern healthcare. However, making teleconsultations available to the entire population covered by a public health system is a challenging goal. Design/methodology/approach This retrospective longitudinal observational study analyzed how this modality was used at the primary care level in Galicia, a region in the Northwest of Spain, in 2014 and 2015, focusing on demand, gender and age preferences, rural vs urban population and efficiency. Findings Of 28,472,852 consultations requested in this period, 9.0 percent were telephone consultations. Women requested more telephone consultations (9.9 percent of total consultations) than men (7.7 percent of total consultations). The highest demand occurred for the over 85 age group for both men and women. In both years, 2014 and 2015, the number of telephone consultations per inhabitant was higher in urban (0.53 and 0.69) than in rural areas (0.34 and 0.47). In 10.9 percent of cases, the telephone consultations required further face-to-face consultation. Originality/value Conventional voice telephone calls can efficiently replace conventional face-to-face consultations in primary healthcare in roughly 10 percent of cases. Women are more likely than men to use primary care services in both face-to-face and telephone consultation modalities. Public healthcare systems should consider implementing telephone consultations to deliver their services.

摘要

目的 本文旨在描述和分析一种基于普通电话(固定电话或移动电话)的远程会诊模式,该模式已提供给超过200万人使用。电信系统在现代医疗保健中越来越普遍。然而,让公共卫生系统覆盖的全体人群都能进行远程会诊是一个具有挑战性的目标。

设计/方法/途径 这项回顾性纵向观察研究分析了2014年和2015年西班牙西北部加利西亚地区初级医疗保健层面这种模式的使用情况,重点关注需求、性别和年龄偏好、农村与城市人口以及效率。

发现 在此期间请求的28472852次会诊中,9.0%是电话会诊。女性请求的电话会诊(占总会诊次数的9.9%)多于男性(占总会诊次数的7.7%)。85岁以上年龄组的男性和女性对电话会诊的需求最高。在2014年和2015年这两年中,城市地区人均电话会诊次数(分别为0.53和0.69)高于农村地区(分别为0.34和0.47)。在10.9%的病例中,电话会诊需要进一步进行面对面会诊。

原创性/价值 在大约10%的病例中,传统语音电话呼叫可以有效地替代初级医疗保健中的传统面对面会诊。在面对面和电话会诊模式下,女性比男性更有可能使用初级医疗保健服务。公共卫生系统应考虑实施电话会诊来提供服务。

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