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个体特征和居住地区如何影响虚拟会诊的需求?

[How the individual characteristics and area of residence influence the request for virtual consultations?].

作者信息

Marco-Ibáñez A, Aguilar-Palacio I, Gamba-Cabezas A, Compés-Dea M L, Aibar Remón C

机构信息

Centro de Salud Casablanca, Servicio Aragonés de Salud, Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.

Universidad de Zaragoza, Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.

出版信息

Semergen. 2024 Nov-Dec;50(8):102296. doi: 10.1016/j.semerg.2024.102296. Epub 2024 Aug 28.

Abstract

INTRODUCTION

The foundation of virtual consultation is to improve the cooperation and the coordination between Primary Care and other specialties. However, in its use inequities related to socioeconomic determinants have been described. The aim of this study was to identify individual and geographical factors affecting the likelihood of accessing this resource.

MATERIAL AND METHODS

Descriptive study of virtual and non-virtual consultations requested by Primary Care doctors from other specialists doctors in Aragon between 1 January 2020 and 31 December 2022. Characteristics of the interconsultations and variables specific to the patient treated were recorded and analyzed; and the request rate for virtual consultations by specialty and the standardized rates by age by Basic Health Zone and stratified by sex were calculated.

RESULTS

Progressive increase in the number of virtual consultations for the study period, being Traumatology, Neurology, Urology, General Surgery and Dermatology the specialties that received the most. The standardized rates by age and stratified by sex were higher in women and the Health Areas of Huesca, Calatayud and Alcañiz. The request was higher in 2022 and the specialized referral was the main type of response. Regarding variables of the patients treated, virtual consultations were requested more in urban and less dispersed areas, women, patients with lower adjusted morbidity and with free pharmacy, pensioners and active users with income less than €18,000/year.

CONCLUSIONS

Despite the rise of telemedicine and its potential advantages, it is necessary to adapt it to the needs of the local population, to mitigate inequalities in access, and to integrate it with face-to-face care.

摘要

引言

虚拟会诊的基础是改善基层医疗与其他专科之间的合作与协调。然而,在其使用过程中,已经发现了与社会经济决定因素相关的不平等现象。本研究的目的是确定影响获取这一资源可能性的个人和地理因素。

材料与方法

对2020年1月1日至2022年12月31日期间阿拉贡地区基层医疗医生向其他专科医生请求的虚拟和非虚拟会诊进行描述性研究。记录并分析会诊的特征以及所治疗患者的特定变量;计算各专科虚拟会诊的请求率以及按基本健康区、性别分层的年龄标准化率。

结果

在研究期间,虚拟会诊数量逐渐增加,创伤科、神经科、泌尿科、普通外科和皮肤科是接收虚拟会诊最多的专科。按年龄、性别分层的标准化率在女性以及韦斯卡、卡拉塔尤德和阿尔卡尼兹的健康区域较高。2022年的请求率更高,专科转诊是主要的回复类型。关于所治疗患者的变量,城市和分散程度较低地区、女性、调整后发病率较低且有免费药房的患者、退休人员以及年收入低于18000欧元的活跃用户请求虚拟会诊的更多。

结论

尽管远程医疗兴起且具有潜在优势,但有必要使其适应当地人群的需求,以减少获取方面的不平等,并将其与面对面护理相结合。

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