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巴西圣保罗州医生对 SARS-CoV-2 大流行期间使用远程医疗的反应:横断面研究。

Reactions of physicians in the state of São Paulo to the use of telemedicine during the SARS-CoV-2 pandemic: cross-sectional study.

机构信息

MD, PhD. Full Professor, Discipline of Anesthesiology, Pain and Intensive Care, Department of Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.

MD. Technology Director, Associação Paulista de Medicina (APM), São Paulo (SP), Brazil; and Chairman, Digital Health Committee, Associação Médica Brasileira (AMB), São Paulo (SP), Brazil.

出版信息

Sao Paulo Med J. 2022 May-Jun;140(3):499-504. doi: 10.1590/1516-3180.2021.0475.R3.03112021.

Abstract

BACKGROUND

Telemedicine can be a component of integrated healthcare practices and its use is not a recent phenomenon around the world. In Brazil, its more widespread use began during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, through extraordinary authorization from the Brazilian Ministry of Health.

OBJECTIVES

To describe some aspects of use of teleconsultation among a sample of physicians in the state of São Paulo during the SARS-CoV-2 pandemic.

DESIGN AND SETTING

Cross-sectional study based on a survey conducted by the São Paulo Medical Association (Associação Paulista de Medicina, APM) on medical practice during the SARS-CoV-2 pandemic between December 18, 2020, and January 18, 2021.

RESULTS

This survey generated responses from 2,052 physicians. Of these, 981 (47.8%) reported not practicing any form of telemedicine. Among those who reported practicing telemedicine, 274 (28.4%) reported not receiving remuneration directly for the attendance provided and 225 (23.3%) reported receiving remuneration equal to what they would have received from face-to-face consultations. Regarding the professional linkage of the physicians who undertook telemedicine attendance, the majority (499; 51.8%) only attended private patients. Regarding the resources used to provide telemedicine attendance, most of the respondents used specialized digital platforms (594; 61.6%), electronic health records (592; 61.4%) and electronic prescriptions (700; 72.6%).

CONCLUSION

This study demonstrates that important issues such as professional remuneration, use of electronic platforms and medical records, ensuring data protection and relationships between physicians and other stakeholders still need to be better defined, in order to achieve the desired scale and reach the outcomes defined.

摘要

背景

远程医疗可以作为综合医疗实践的一个组成部分,其使用在全球范围内并不是一个新现象。在巴西,它的更广泛应用始于严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)大流行期间,通过巴西卫生部的特别授权。

目的

描述在 SARS-CoV-2 大流行期间圣保罗州医生样本中远程咨询使用的一些方面。

设计和设置

基于圣保罗医师协会(Associação Paulista de Medicina,APM)在 2020 年 12 月 18 日至 2021 年 1 月 18 日期间对 SARS-CoV-2 大流行期间医疗实践进行的调查,这是一项横断面研究。

结果

这项调查收到了 2052 名医生的回复。其中,981 名(47.8%)报告没有进行任何形式的远程医疗。在报告进行远程医疗的医生中,274 名(28.4%)报告没有直接因提供的就诊获得报酬,225 名(23.3%)报告获得的报酬与面对面咨询相同。关于进行远程医疗就诊的医生的专业联系,大多数(499 名;51.8%)只接待私人患者。关于提供远程医疗就诊所使用的资源,大多数受访者使用了专门的数字平台(594 名;61.6%)、电子健康记录(592 名;61.4%)和电子处方(700 名;72.6%)。

结论

本研究表明,专业报酬、使用电子平台和病历、确保数据保护以及医生与其他利益相关者之间的关系等重要问题仍需更好地界定,以实现预期的规模和达到既定的结果。

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