Structure and working process to implement medical teleconsultation in the Unified Health System in Brazil, a cross sectional study using data from 2017-2018

• Author(s): Catapan, Soraia de Camargo ; Willemann, Maria Cristina Antunes ; Calvo, Maria Cristina Marino
• Date: 2020
• Origin: Oasisbr
• Subject(s): Telemedicina; Consulta Remota; Tecnologia da Informação; Formulação de Políticas; Estudos Transversais; Telemedicine; Remote Consultation; Information Technology; Cross-Sectional Studies; Health Services Research; Policy Making
• Document Type: Other
• Language: Portuguese

Description

Objective: To compare structure and working process at primary care to implement medical teleconsultation in municipalities of different regions and population sizes (thousand inhabitants: <25; 25-100; >100). Methods: Cross-sectional study, with descriptive and bivariate analysis, using data from 2017-2018 to assess the availability of a computer with internet access, webcam, microphone, speaker and teams working processes (telehealth use, and existence of central regulation and communication between the teams). Results: 30,346 health units and 38,865 teams were evaluated. The presence of teleconsultation equipment in the units ranged from 1.2% in large northern municipalities to 26.7% in small southern municipalities. The working process to implement teleconsultation ranged from 10.7% in small northern municipalities to 39.5% in large southern municipalities. Compared to the South, medium municipalities in the North (OR=0.14 – CI95% 0.11;0.17) and Northeast (OR=0.21 – CI95% 0.18;0.25) regions were less likely to have necessary equipment. Conclusion: Investments in Digital Health are needed, with significant regional inequalities.

Objetivo: Comparar estrutura e processo de trabalho na Atenção Básica para implantação da teleconsulta médica em municípios de diferentes regiões e portes populacionais (mil habitantes: <25; 25-100; >100). Métodos: Estudo transversal, com análise descritiva e bivariada, sobre dados de 2017-2018, para avaliar disponibilidade de computador com internet, câmera, microfone e caixa de som, e processo de trabalho das equipes (utilizar Telessaúde, central de regulação e fluxo de comunicação). Resultados: Analisadas 30.346 UBS e 38.865 equipes, a presença de equipamentos para teleconsulta entre UBS variou de 1,2% em municípios grandes do Norte a 26,7% em municípios pequenos do Sul. O processo de trabalho variou de 10,7% em municípios pequenos do Norte a 39,5% em municípios grandes do Sul. Comparados ao Sul, municípios médios do Norte (OR=0,14 – IC95% 0,11;0,17) e do Nordeste (OR=0,21 – IC95% 0,18;0,25) tiveram menores chances de dispor dos equipamentos necessários. Conclusão: Significativas desigualdades regionais recomendam investimentos em Saúde Digital.