Daniel Rey-Aldana1, Sergio Cinza-Sanjurjo2, Manuel Portela-Romero3, José L López-Barreiro4, Alberto Garcia-Castelo4, José M Pazos-Mareque4, Pilar Mazón-Ramos5, José R González-Juanatey6. 1. Centro de Saude A Estrada, Área Sanitaria Integrada Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain. 2. Centro de Saude Porto do Son, Área Sanitaria Integrada Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain. 3. Centro de Saude Concepción Arenal, Área Sanitaria Integrada Santiago de Compostela, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, A Coruña, Spain. 4. Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain. 5. Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. 6. Servicio de Cardiología, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: jose.ramon.gonzalez.juanatey@sergas.es.
Abstract
INTRODUCTION AND OBJECTIVES: Many health systems have initiated electronic consultation (e-consultation) programs, although little is known about their impact on accessibility, safety, and satisfaction. The aim of this study was to assess the clinical impact of the implementation of an outpatient care model that includes an initial e-consultation and to compare it with a one-time face-to-face consultation model. METHODS: We selected patients who visited the cardiology service at least once between 2010 and 2019. Using an interrupted time series regression model, we analyzed the impact of incorporating e-consultation into the health care model (started in 2013), and evaluated waiting times, emergency services, hospital admissions, and mortality. RESULTS: We analyzed 47 377 patients: 61.9% were attended in e-consultation and 38.1% in one-time face-to-face consultations. The waiting time for care was shorter in the e-consultation model (median [IQR]: 7 [5-13] days) than in the face-to-face model (median [IQR]: 33 [14-81] days), P<.001. The interrupted time series regression model showed that the introduction of e-consultation substantially decreased waiting times, which held steady at around 9 days, although with slight oscillations. Patients evaluated via e-consultation had fewer hospital admissions (0.9% vs 1.2%, P=.0017) and lower mortality (2.5% vs 3.9%, P<.001). CONCLUSIONS: An outpatient care program that includes an e-consultation reduced waiting times significantly and was safe, with a lower rate of hospital admissions and mortality in the first year.
INTRODUCTION AND OBJECTIVES: Many health systems have initiated electronic consultation (e-consultation) programs, although little is known about their impact on accessibility, safety, and satisfaction. The aim of this study was to assess the clinical impact of the implementation of an outpatient care model that includes an initial e-consultation and to compare it with a one-time face-to-face consultation model. METHODS: We selected patients who visited the cardiology service at least once between 2010 and 2019. Using an interrupted time series regression model, we analyzed the impact of incorporating e-consultation into the health care model (started in 2013), and evaluated waiting times, emergency services, hospital admissions, and mortality. RESULTS: We analyzed 47 377 patients: 61.9% were attended in e-consultation and 38.1% in one-time face-to-face consultations. The waiting time for care was shorter in the e-consultation model (median [IQR]: 7 [5-13] days) than in the face-to-face model (median [IQR]: 33 [14-81] days), P<.001. The interrupted time series regression model showed that the introduction of e-consultation substantially decreased waiting times, which held steady at around 9 days, although with slight oscillations. Patients evaluated via e-consultation had fewer hospital admissions (0.9% vs 1.2%, P=.0017) and lower mortality (2.5% vs 3.9%, P<.001). CONCLUSIONS: An outpatient care program that includes an e-consultation reduced waiting times significantly and was safe, with a lower rate of hospital admissions and mortality in the first year.
Authors: Jose Seijas-Amigo; Mónica Gayoso-Rey; María José Mauriz-Montero; Pedro Suarez-Artime; Antonia Casas-Martinez; María Dominguez-Guerra; Lara Gonzalez-Freire; Ana Estany-Gestal; Alberto Codero-Fort; Moisés Rodriguez-Mañero; Jose Ramón Gonzalez-Juanatey Journal: Clin Investig Arterioscler Date: 2022-02-03
Authors: Sergio Cinza Sanjurjo; Pilar Mazón Ramos; Diego Iglesias Álvarez; Daniel Rey Aldana; Manuel Portela Romero; José R González-Juanatey Journal: Rev Esp Cardiol Date: 2021-07-07 Impact factor: 4.753