Remote consultations in primary care across low-, middle- and high-income countries: Implications for policy and care delivery.

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2023-07-01 DOI:10.1177/13558196221140318
Siân Williams, Amanda Barnard, Phil Collis, Jaime Correia de Sousa, Suraj Ghimire, Monsur Habib, Tessa Jelen, Frank Kanniess, Vince Mak, Sonia Martins, Ema Paulino, Hilary Pinnock, Miguel Roman, Hanna Sandelowsky, Ioanna Tsiligianni, Laurine van der Steen, Fabio Weber Donatelli
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引用次数: 2

Abstract

The COVID-19 pandemic mandated a substantial switch in primary health care delivery from an in-person to a mainly remote telephone or video service. As the COVID-19 pandemic approaches its third year, limited progress appears to have been made in terms of policy development around consultation methods for the post-acute phase of the pandemic. In September 2020, the International Primary Care Respiratory Group convened a global panel of primary care clinicians - including family physicians, paediatricians, pharmacists, academics and patients - to consider the policy and health management implications of the move to remote consultations in the primary care setting. The group gave special consideration to how and how far remote consultations should be integrated into routine primary health care delivery. Remote consultations can be a useful alternative to in-person consultations in primary care not only in situations where there is a need for viral infection control but also for the routine delivery of chronic disease management. However, they may not be more time efficient for the clinician, and they can add to the workload and work-related stress for primary care practitioners if they remain the dominant consultation mode. Remote consultations are also less appropriate than in-person consultations for new disease diagnosis, dealing with multiple issues and providing complex care. Ensuring health care professionals have the appropriate skill set to effectively deliver remote consultations, administrative and/or IT support and appropriate reimbursement will be key to achieving optimal integration of remote consultations into routine clinical practice. Addressing digital access and digital literacy issues at a societal level will also be essential to ensure individuals have fair and equitable access to the internet and sufficient security for exchange of personal and health-related data.

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低、中、高收入国家初级保健远程会诊:对政策和保健服务的影响
2019冠状病毒病大流行迫使初级卫生保健服务从面对面服务大幅转变为主要是远程电话或视频服务。随着COVID-19大流行进入第三个年头,围绕大流行急性期后磋商方法的政策制定似乎取得了有限进展。2020年9月,国际初级保健呼吸小组召集了一个由初级保健临床医生(包括家庭医生、儿科医生、药剂师、学者和患者)组成的全球小组,审议在初级保健环境中转向远程会诊的政策和健康管理影响。该小组特别考虑了远程咨询应如何以及在多大程度上纳入常规初级卫生保健服务。在初级保健中,远程会诊不仅在需要控制病毒感染的情况下,而且在常规提供慢性病管理的情况下,都可以成为面对面会诊的有用替代方案。然而,对于临床医生来说,他们可能没有更多的时间效率,如果他们仍然是主要的咨询模式,他们可能会增加初级保健医生的工作量和工作压力。在新疾病诊断、处理多重问题和提供复杂护理方面,远程咨询也不如面对面咨询合适。确保医疗保健专业人员具备适当的技能,能够有效地提供远程咨询、行政和/或IT支持以及适当的报销,将是实现远程咨询与常规临床实践最佳整合的关键。在社会层面解决数字获取和数字扫盲问题对于确保个人公平和公平地使用互联网以及交换个人和健康相关数据的充分安全也至关重要。
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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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