Identification of indicators used to assess needs for telemedical consultations in various profiles of medical care

Digital Diagnostics Pub Date : 2024-01-29 DOI:10.17816/dd622846

E. S. Samsonova, I. Mikhailov, V. V. Omelyanovsky, M. V. Avksentieva, I. Zheleznyakova, G. G. Lebedenko

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Abstract

Background: Unified system for assessing the results and real contribution of of telemedicine consultations (TMC) to improving the quality of medical care in the healthcare system of the Russian Federation has not yet been developed. Aim: Development of a system of indicators for differentiated assessment of the need for TMC in the provision of medical care of various profiles. Materials and methods: At the first stage we analyzed reports on the results of on-site activities of NMRCs in regions of the Russian Federation and annual public reports of NMRCs (2020-2022) to identify indicators that determine the need for TMC. The identified indicators were clarified and validated in an open interview with representatives of the NMRCs. At the second stage we determined the value of each indicator on the bases of expert survey. 18 experts had to score each indicator from 1 to 5. Then we calculated the weight coefficient of each indicator for their subsequent use in planning TMC volumes. Results: Three groups of indicators have been identified. The first group includes indicators of mortality, disability and hospital mortality, the frequency of emergency/urgent consultations and the frequency of consultations of intensive care patients. The second group includes indicators for assessing the effectiveness and efficiency of TMC, subjective (satisfaction with the results of TMC) and objective (the number of positive and negative disease and hospitalization cases outcomes for which TMC was performed). The third group includes indicators characterizing the validity of requests for TMС: patients examination completeness of before TMC, diagnosis accuracy. The weight coefficients of the indicators of the first group ranged from 0.05 to 1.61 and were different for different profiles. Conclusion: A system of indicators has been proposed for differentiated assessment of the need for TMC when providing medical care of different profiles.

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确定用于评估各种医疗保健远程医疗咨询需求的指标

背景：目前尚未建立统一的系统来评估远程医疗会诊（TMC）在提高俄罗斯联邦医疗系统医疗质量方面的成果和实际贡献。目的：开发一套指标体系，用于区别评估在提供各种医疗服务时对远程医疗会诊的需求。材料和方法：在第一阶段，我们分析了俄罗斯联邦各地区国家医疗中心的现场活动结果报告以及国家医疗中心的年度公开报告（2020-2022 年），以确定确定 TMC 需求的指标。通过与国家监测和研究中心的代表进行公开访谈，对确定的指标进行了澄清和验证。在第二阶段，我们根据专家调查确定了每个指标的价值。18 位专家必须对每个指标从 1 到 5 进行打分。然后，我们计算出每项指标的权重系数，以便随后在规划 TMC 数量时使用。结果：我们确定了三组指标。第一组指标包括死亡率、残疾率和住院死亡率、急诊/急诊就诊频率以及重症监护病人就诊频率。第二组指标包括评估治疗管理的效果和效率的指标、主观指标（对治疗管理结果的满意度）和客观指标（进行了治疗管理的疾病和住院病例的阳性和阴性结果的数量）。第三组包括表征 TMС 申请有效性的指标：TMC 前病人检查的完整性、诊断的准确性。第一组指标的权重系数从 0.05 到 1.61 不等，不同情况的指标权重系数不同。结论提出了一套指标体系，用于在提供不同情况的医疗服务时，对是否需要进行全套医疗管理进行区别评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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