González Cristian, Guajardo Hernán, Martínez María Soledad, Rodríguez Víctor, Aravena Carmen, Vergara Antonio, Duarte Ana, Wilhelm Pablo, Vance Carina
Organización Panamericana de la Salud Santiago Chile Organización Panamericana de la Salud, Santiago, Chile.
División de Prevención y Control de Enfermedades Subsecretaría de Salud Pública Ministerio de Salud Santiago Chile. División de Prevención y Control de Enfermedades, Subsecretaría de Salud Pública, Ministerio de Salud, Santiago, Chile.
Rev Panam Salud Publica. 2025 Jul 15;49:e68. doi: 10.26633/RPSP.2025.68. eCollection 2025.
Describe and examine the use of the digital telehealth strategy in primary health care (PHC) facilities in Chile, describe its implementation in the country, and analyze its impact on demand management within the Chilean health system.
A cross-sectional descriptive observational study was conducted in 320 PHC facilities in the telehealth system. All requests for care registered on the platform were analyzed using anonymized data from the panel of telehealth indicators. Studied variables included: volume of requests, distribution by sex and age, variability in demand, percentage of requests resolved remotely, and waiting times according to clinical priority level. A descriptive analysis of frequencies and proportions was performed, and an estimate was made of the impact of telehealth in terms of reducing in-person visits.
Between January 2021 and December 2024, 5 037 145 requests from 1 292 942 individuals were received on the telehealth platform, with a higher participation of women (64.4%). The predominant age group was 25 to 65 years (49.8%). Demand was highest in October and November; February and December were the least active months. A total of 23.45% of users enrolled in PHC used telehealth services at least once. Of the total number of requests, 28.4% were handled remotely, 62.7% required in-person attention, and 6.4% were closed for administrative reasons. Waiting times for high-priority requests averaged eight days, which is above the recommended standard of 24 to 48 hours.
Telehealth has proven to be an effective strategy for demand management in PHC, with high adoption among working-age adults. However, challenges remain in terms of managing high-priority requests and ensuring equity of digital access for older adults. It is recommended to strengthen the integration of high-quality telemedicine services and to improve response times based on clinical urgency in order to optimize the strategy's impact on access to health care.
描述并考察智利初级卫生保健（PHC）机构中数字远程医疗策略的使用情况，阐述其在该国的实施情况，并分析其对智利卫生系统内需求管理的影响。
在远程医疗系统的320家初级卫生保健机构开展了一项横断面描述性观察研究。利用远程医疗指标面板中的匿名数据，对平台上登记的所有护理请求进行了分析。研究变量包括：请求量、按性别和年龄分布、需求变化、远程解决的请求百分比以及根据临床优先级别的等待时间。进行了频率和比例的描述性分析，并估计了远程医疗在减少面对面就诊方面的影响。
2021年1月至2024年12月期间，远程医疗平台共收到来自1292942人的5037145份请求，女性参与率更高（64.4%）。主要年龄组为25至65岁（49.8%）。需求在10月和11月最高；2月和12月是最不活跃的月份。在初级卫生保健机构注册的用户中，共有23.45%至少使用过一次远程医疗服务。在所有请求中，28.4%得到远程处理，62.7%需要面对面就诊，6.4%因行政原因关闭。高优先级请求的平均等待时间为8天，高于建议的24至48小时标准。
远程医疗已被证明是初级卫生保健中需求管理的有效策略，在工作年龄成年人中采用率较高。然而，在管理高优先级请求以及确保老年人数字接入公平性方面仍存在挑战。建议加强高质量远程医疗服务的整合，并根据临床紧急情况改善响应时间，以优化该策略对医疗保健可及性的影响。
