Flores Ricardo, Donoso Rodrigo, Anguita Rodrigo
Departamento de Oftalmología, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
Rev Med Chil. 2019 Apr;147(4):444-450. doi: 10.4067/S0034-98872019000400444.
If we are able to increase the resolution of complex medical problems at primary health care levels, we would improve the efficiency of the health care systems and would reduce the burden of specialists.
To describe the result of a telemedicine and network management of diabetic retinopathy supervised by an ophthalmological service.
Diabetic patients attended in primary health care centers of the East Metropolitan Health Service in Santiago, Chile, derived for 45° digital retinographies were evaluated using telemedicine by the ophthalmologists of the base hospital. These professionals screened for diabetic retinopathy and classified it. Those patients with diabetic retinopathy were derived to the base hospital for specialized management.
Of 2,566 patients evaluated, 22% had signs of diabetic retinopathy, 75% did not have the condition and 2% could not be evaluated with retinography. Seventy percent of patients with retinopathy, equivalent to only fifteen percent of total diabetics, were referred to the specialists for treatment.
This model allowed a reduction of referrals to ophthalmologists, reducing the burden of secondary and tertiary health care systems.
如果我们能够在初级卫生保健层面提高对复杂医疗问题的解决能力，就能提高卫生保健系统的效率，并减轻专科医生的负担。
描述由眼科服务机构监督的糖尿病视网膜病变远程医疗和网络管理的结果。
在智利圣地亚哥东大都会卫生服务中心的初级卫生保健中心就诊的糖尿病患者，经45°数字视网膜造影检查后，由基层医院的眼科医生通过远程医疗进行评估。这些专业人员对糖尿病视网膜病变进行筛查并分类。患有糖尿病视网膜病变的患者被转至基层医院接受专科治疗。
在2566名接受评估的患者中，22%有糖尿病视网膜病变迹象，75%没有这种情况，2%无法通过视网膜造影进行评估。70%的视网膜病变患者（仅占糖尿病患者总数的15%）被转诊至专科医生处接受治疗。
该模式减少了转诊至眼科医生处的患者数量，减轻了二级和三级卫生保健系统的负担。
