西班牙安达卢西亚地区基于远程医疗的普通皮肤科初始诊疗短期计划的可行性与成本

Feasibility and cost of a telemedicine-based short-term plan for initial access in general dermatology in Andalusia, Spain.

作者信息

Barros-Tornay Ruben, Ferrándiz Lara, Martín-Gutiérrez Francisco J, Fernández-Orland Almudena, Serrano-Gotarredona Amalia, de la Torre José M, Conejo-Mir María D, Ojeda-Vila Teresa, Márquez-Enríquez Juan, Hernández Carlos, Ocaña María J, Herrerías-Esteban Juan M, Moreno-Ramírez David

机构信息

Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain.

Dermatology Unit, Hospital Universitario de Jerez de la Frontera, Cádiz, Spain.

出版信息

JAAD Int. 2021 Jul 8;4:52-57. doi: 10.1016/j.jdin.2021.05.002. eCollection 2021 Sep.

DOI:10.1016/j.jdin.2021.05.002

PMID:34409393

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8362296/

Abstract

BACKGROUND

In developed countries, health care delivery in dermatology is hampered by the low availability of dermatologists.

OBJECTIVE

To analyze the feasibility of a teledermatology-based action plan to provide initial dermatologic care in areas with low availability of dermatologists.

METHODS

A cross-sectional study describing the feasibility and cost of a 12-month action plan based on a store-and-forward teledermatology (TD) connecting primary care centers and a TD center. Teleconsultations from patients complaining of any cutaneous condition were included. The primary outcome measure was the percentage of patients not referred to the local dermatologist.

RESULTS

Among the total of 15,523 teleconsultations attended in the TD-based action plan, 3360 (21.65%) required a face-to-face visit with a local dermatologist. In 32.32% (n = 5017) of the cases, a therapeutic and follow-up plan report was issued. The most common conditions managed were melanocytic nevi (15.63%, n = 2426), followed by seborrheic keratosis (14.89%, n = 2312), and actinic keratosis (8.65%, n = 1342). The average response time was 14.52 days (95% CI 14.35-15.23). The additional total investment in this action plan was $142,681.01, with a unit cost of 9.20$/patient.

LIMITATIONS

Noncontrolled study.

CONCLUSIONS

Experienced dermatologists working with store-and-forward TD can deliver a fast and effective response in health care areas with access limitations.

摘要

背景

在发达国家，皮肤科医疗服务因皮肤科医生数量不足而受到阻碍。

目的

分析基于远程皮肤病学的行动计划在皮肤科医生数量不足地区提供初始皮肤科护理的可行性。

方法

一项横断面研究，描述基于存储转发远程皮肤病学（TD）连接基层医疗中心和TD中心的12个月行动计划的可行性和成本。纳入了抱怨任何皮肤状况的患者的远程会诊。主要结局指标是未转诊至当地皮肤科医生的患者百分比。

结果

在基于TD的行动计划中总共进行的15523次远程会诊中，3360例（21.65%）需要与当地皮肤科医生进行面对面就诊。在32.32%（n = 5017）的病例中，发布了治疗和随访计划报告。处理的最常见病症是黑素细胞痣（15.63%，n = 2426），其次是脂溢性角化病（14.89%，n = 2312）和光化性角化病（8.65%，n = 1342）。平均响应时间为14.52天（95%可信区间14.35 - 15.23）。该行动计划的额外总投资为142681.01美元，单位成本为9.20美元/患者。