Health Department, Catalan Ministry of Health, Barcelona, Spain.
Digitalization for the Sustainability of the Healthcare System, Sistema de Salut de Catalunya, Barcelona, Spain.
J Med Internet Res. 2021 May 27;23(5):e28629. doi: 10.2196/28629.
eConsulta-that is, asynchronous, two-way teleconsultation in primary care-is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the onset of the COVID-19 pandemic. It is vital to know the characteristics of its users in order to be able to meet their needs and understand the coverage of this service in a context where there is reduced accessibility to the health system.
This study aims to analyze the profile of the citizens who use the eConsulta tool and the reasons for their use, as well as to gain an understanding of the elements that characterize their decision to use it while distinguishing between those who used it before and those who have used it since the onset of the COVID-19 pandemic.
A descriptive, observational study based on administrative data was performed. This study differentiates between the COVID-19 pandemic era and the period preceding it, considering the day the state of emergency was declared in Spain (ie, March 12, 2020) as the cut-off point. It also differentiates between eConsulta users who send messages and those who only receive them.
During the pandemic, the number of unique users of this teleconsultation service had almost tripled, with up to 33.10 visits per 1000 inhabitants per month reported in the first three months. For the two user profiles analyzed, most users since the start of the COVID-19 outbreak were predominantly female, systematically younger, more actively employed, and with less complex pathologies. Furthermore, eConsulta users received more messages proactively from the health professionals. There was also a relative decrease in the number of conversations initiated by higher-income urban users and an increase in conversations initiated by users in rural areas.
The COVID-19 pandemic has helped to generalize the use of telemedicine as a tool to compensate, to some extent, for the decline in face-to-face visits, especially among younger citizens in Catalonia. Telemedicine has made it possible to maintain contact between citizens and the health care system in the context of maximum complexity.
电子咨询（即初级保健中的异步双向远程咨询）是加泰罗尼亚公共卫生系统中最重要的远程医疗发展之一，该服务在 COVID-19 大流行期间得到了大力推动。了解其用户的特点对于满足他们的需求以及了解在卫生系统可及性降低的情况下该服务的覆盖范围至关重要。
本研究旨在分析使用电子咨询工具的公民的特征及其使用原因，并了解他们决定使用该工具的特征，同时区分那些在 COVID-19 大流行之前使用该工具的人和那些在 COVID-19 大流行之后开始使用该工具的人。
本研究是一项基于行政数据的描述性观察研究。本研究将大流行时期与之前的时期区分开来，以西班牙宣布紧急状态的那一天（即 2020 年 3 月 12 日）为分界点。它还区分了发送消息的电子咨询用户和仅接收消息的用户。
在大流行期间，这种远程咨询服务的唯一用户数量几乎增加了两倍，在前三个月报告的每月每 1000 名居民中有 33.10 次访问。对于分析的两个用户档案，自 COVID-19 爆发以来，大多数用户主要是女性，系统地更年轻，更积极地就业，并且患有不太复杂的疾病。此外，电子咨询用户更积极地收到了来自卫生专业人员的消息。高收入城市用户发起的对话数量相对减少，农村用户发起的对话数量增加。
COVID-19 大流行帮助将远程医疗作为一种工具普及化，在一定程度上弥补了面对面就诊的减少，尤其是在加泰罗尼亚的年轻公民中。远程医疗使公民在最大程度的复杂性背景下与医疗保健系统保持联系成为可能。
