Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos de neuro-psiquiatria (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400299 |
Resumo: | ABSTRACT Background: Brazil’s public health system, the largest in the world, faces great challenges in establishing access to specialized care for all Brazilians. “Regula Mais Brasil” is a structuring project from the Ministry of Health that aims to optimize the referral process for specialized care throughout Brazil and uses telemedicine to support primary care physicians. The high demand for support and referrals in the neurology specialty raises questions about what the difficulties and doubts in managing these patients are and whether the training of the coordinating physician influences the orientation and outcome of referral. Methods: In a retrospective analysis on a database, all teleconsultations in the neurology specialty were evaluated. The diagnoses were categorized using the ICD-10 and according to the specialty of the coordinating teleconsultant for multiple comparisons. Results: In total, 1687 teleconsultations were conducted between January 10 and December 2, 2019, in the cities of Belo Horizonte and Porto Alegre and in the Federal District. The most frequent area of doubt for doctors was about epilepsy. After discussion via telemedicine, 25% of the referrals were avoided and the specialty of the teleconsultant physician did not impact the decision made: 72.3, 72.6 and 66.5%, in relation to approval by neurologists, family doctors and other experts, respectively. Conclusion: Increasing access to specialists, not only for patients but also for doctors, helps in achieving early resolution of issues of greater difficulty for primary healthcare doctors, thus resulting in lower numbers of referrals. |
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Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phoneTelemedicineHealth Services Accessibility, Health EquityPrimary Health CareNeurologyABSTRACT Background: Brazil’s public health system, the largest in the world, faces great challenges in establishing access to specialized care for all Brazilians. “Regula Mais Brasil” is a structuring project from the Ministry of Health that aims to optimize the referral process for specialized care throughout Brazil and uses telemedicine to support primary care physicians. The high demand for support and referrals in the neurology specialty raises questions about what the difficulties and doubts in managing these patients are and whether the training of the coordinating physician influences the orientation and outcome of referral. Methods: In a retrospective analysis on a database, all teleconsultations in the neurology specialty were evaluated. The diagnoses were categorized using the ICD-10 and according to the specialty of the coordinating teleconsultant for multiple comparisons. Results: In total, 1687 teleconsultations were conducted between January 10 and December 2, 2019, in the cities of Belo Horizonte and Porto Alegre and in the Federal District. The most frequent area of doubt for doctors was about epilepsy. After discussion via telemedicine, 25% of the referrals were avoided and the specialty of the teleconsultant physician did not impact the decision made: 72.3, 72.6 and 66.5%, in relation to approval by neurologists, family doctors and other experts, respectively. Conclusion: Increasing access to specialists, not only for patients but also for doctors, helps in achieving early resolution of issues of greater difficulty for primary healthcare doctors, thus resulting in lower numbers of referrals.Academia Brasileira de Neurologia - ABNEURO2021-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400299Arquivos de Neuro-Psiquiatria v.79 n.4 2021reponame:Arquivos de neuro-psiquiatria (Online)instname:Academia Brasileira de Neurologiainstacron:ABNEURO10.1590/0004-282x-anp-2020-0137info:eu-repo/semantics/openAccessMANTESE,Carlos EduardoAQUINO,Emanuelle Roberta da SilvaFIGUEIRA,Mariana DuqueRODRIGUES,LiviaBASSO,JosueRAUPP DA ROSA,Priscilaeng2021-06-07T00:00:00Zoai:scielo:S0004-282X2021000400299Revistahttp://www.scielo.br/anphttps://old.scielo.br/oai/scielo-oai.php||revista.arquivos@abneuro.org1678-42270004-282Xopendoar:2021-06-07T00:00Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologiafalse |
dc.title.none.fl_str_mv |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
title |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
spellingShingle |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone MANTESE,Carlos Eduardo Telemedicine Health Services Accessibility, Health Equity Primary Health Care Neurology |
title_short |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
title_full |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
title_fullStr |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
title_full_unstemmed |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
title_sort |
Telemedicine as support for primary care referrals to neurologists: decision-making between different specialists when guiding the case over the phone |
author |
MANTESE,Carlos Eduardo |
author_facet |
MANTESE,Carlos Eduardo AQUINO,Emanuelle Roberta da Silva FIGUEIRA,Mariana Duque RODRIGUES,Livia BASSO,Josue RAUPP DA ROSA,Priscila |
author_role |
author |
author2 |
AQUINO,Emanuelle Roberta da Silva FIGUEIRA,Mariana Duque RODRIGUES,Livia BASSO,Josue RAUPP DA ROSA,Priscila |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
MANTESE,Carlos Eduardo AQUINO,Emanuelle Roberta da Silva FIGUEIRA,Mariana Duque RODRIGUES,Livia BASSO,Josue RAUPP DA ROSA,Priscila |
dc.subject.por.fl_str_mv |
Telemedicine Health Services Accessibility, Health Equity Primary Health Care Neurology |
topic |
Telemedicine Health Services Accessibility, Health Equity Primary Health Care Neurology |
description |
ABSTRACT Background: Brazil’s public health system, the largest in the world, faces great challenges in establishing access to specialized care for all Brazilians. “Regula Mais Brasil” is a structuring project from the Ministry of Health that aims to optimize the referral process for specialized care throughout Brazil and uses telemedicine to support primary care physicians. The high demand for support and referrals in the neurology specialty raises questions about what the difficulties and doubts in managing these patients are and whether the training of the coordinating physician influences the orientation and outcome of referral. Methods: In a retrospective analysis on a database, all teleconsultations in the neurology specialty were evaluated. The diagnoses were categorized using the ICD-10 and according to the specialty of the coordinating teleconsultant for multiple comparisons. Results: In total, 1687 teleconsultations were conducted between January 10 and December 2, 2019, in the cities of Belo Horizonte and Porto Alegre and in the Federal District. The most frequent area of doubt for doctors was about epilepsy. After discussion via telemedicine, 25% of the referrals were avoided and the specialty of the teleconsultant physician did not impact the decision made: 72.3, 72.6 and 66.5%, in relation to approval by neurologists, family doctors and other experts, respectively. Conclusion: Increasing access to specialists, not only for patients but also for doctors, helps in achieving early resolution of issues of greater difficulty for primary healthcare doctors, thus resulting in lower numbers of referrals. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400299 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2021000400299 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0004-282x-anp-2020-0137 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia - ABNEURO |
dc.source.none.fl_str_mv |
Arquivos de Neuro-Psiquiatria v.79 n.4 2021 reponame:Arquivos de neuro-psiquiatria (Online) instname:Academia Brasileira de Neurologia instacron:ABNEURO |
instname_str |
Academia Brasileira de Neurologia |
instacron_str |
ABNEURO |
institution |
ABNEURO |
reponame_str |
Arquivos de neuro-psiquiatria (Online) |
collection |
Arquivos de neuro-psiquiatria (Online) |
repository.name.fl_str_mv |
Arquivos de neuro-psiquiatria (Online) - Academia Brasileira de Neurologia |
repository.mail.fl_str_mv |
||revista.arquivos@abneuro.org |
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1754212788384825344 |