Calidad de la atención en el Servicio de Telesalud en el contexto de la pandemia, revisión bibliográfica
Texto completo:
PDFResumen
Introducción: la Telesalud en épocas de pandemia se convirtió en una alternativa para la atención de pacientes debido a las medidas de confinamiento social y fue utilizada tanto en la atención primaria como en las diferentes especialidades médicas, con niveles de satisfacción similares a la consulta presencial.
Objetivos: evaluar la calidad de la atención del Servicio de Telesalud en el contexto de pandemia y determinar los beneficios y las barreras que dificultan este tipo de atención.
Métodos: mediante un proceso sistemático se accedió a documentos de diferentes bases de datos como Scopus, ScienceDirect, SciELO, Google académico y Proquest en el período comprendido entre 2018 y 2022, en inglés y español, de acceso abierto e investigaciones de tipo descriptivas; se utilizaron los descriptores calidad de atención, calidad, telesalud y satisfacción. Se valoró su calidad, se analizaron sus resultados y se sistematizaron críticamente sus aportes.
Conclusiones: no hay diferencias entre la calidad de la atención en Telesalud y la atención tradicional, sus principales beneficios radican en el acceso a la atención y la reducción de costos y sus barreras son los problemas de brechas tecnológicas y la falta de capacitación en el personal de salud en su uso.
Palabras clave
Referencias
Medical News Today [Internet]. Brighton: Healthline Media UK Ltd; 2023 [actualizado 22/11/2022; citado 08/05/2023]. Martinez K, Villines Z, Davenport S. Best telemedicine companies: telemedicine benefits and more; [aprox. 25 tantallas]. Disponible en: https://www.medicalnewstoday.com/articles/telemedicine-benefits
gob.pe [Internet]. Lima: Plataforma digital única del Estado Peruano; 2021 [actualizado 10/01/2021; citado 13/12/2021]. ¿Qué es Telesalud?; [aprox. 1 pantalla]. Disponible en: https://www.gob.pe/11729-que-es-telesalud-servicios-de-telemedicina
Organización Panamericana de la Salud [Internet]. Washington: OPS; 2021 [actualizado 04/01/2021; citado 03/07/2021]. Teleconsulta durante una Pandemia. Disponible en: https://www3.paho.org/ish/images/docs/covid-19-teleconsultas-es.pdf
Centers for Disease Control and Prevention [Internet]. Atlanta: CDC; 2021 [actualizado 11/05/2020; citado 03/07/2021]. Telehealth Interventions to Improve Chronic Disease; [aprox. 5 pantallas]. Disponible en: https://www.cdc.gov/dhdsp/pubs/telehealth.htm
Prasad A, Brewster R, Newman JG, Rajasekaran K. Optimizing your telemedicine visit during the COVID‐19 pandemic: Practice guidelines for patients with head and neck cancer. Head Neck [Internet]. 2020 [citado 03/07/2021];42(6):1317-21. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267295/. https://doi.org/10.1002/hed.26197
Diniz Vieira Silva CR, Horácio Lopes R, de Goes Bay Júnior O, Fuentealba-Torres M, Arcêncio RA, da Costa Uchôa SA. Telemedicine in primary healthcare for the quality of care in times of COVID-19: a scoping review protocol. BMJ Open [Internet]. 2021 [citado 01/07/2021];11(7):e046227. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8277488/. https://doi.org/10.1136/bmjopen-2020-046227
Weaver MS, Lukowski J, Wichman B, Navaneethan H, Fisher AL, Neumann ML. Human Connection and Technology Connectivity: A Systematic Review of Available Telehealth Survey Instruments. J Pain Symptom Manage [Internet]. 2021 [citado 03/07/2021];61(5):1042-1051.e2. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556265/. https://doi.org/10.1016/j.jpainsymman.2020.10.010
Healthcare IT News [Internet]. Portland: Healthcare IT News; 2021 [actualizado 30/06/2021; citado 03/07/2021]. Jercich K. Report: Telehealth use beginning to taper; [aprox. 3 pantallas]. Disponible en: https://www.healthcareitnews.com/news/report-telehealth-use-beginning-taper
Dorsey ER, Topol EJ. Telemedicine 2020 and the next decade. Lancet [Internet]. 2020 [citado 03/07/2021];395(10227):859. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32171399/. https://doi.org/10.1016/S0140-6736(20)30424-4
WINK [Internet]. Fort Mayer: Wink News; 2021 [actualizado 20/06/2021; citado 03/07/2021]. Lowenstein J, Marshall V. Losing out on telehealth perks after emergency order expires; [aprox. 3 pantallas]. Disponible en: https://www.winknews.com/2021/06/30/losing-out-on-telehealth-perks-after-emergency-order-expires/
Blackwell J. Telehealth acceptance has grown during pandemic. J Bus [Internet]. 2021 [citado 03/07/2021]. Disponible en: https://www.spokanejournal.com/local-news/telehealth-acceptance-has-grown-during-pandemic/
Biruk K, Abetu E. Knowledge and Attitude of Health Professionals toward Telemedicine in Resource-Limited Settings: A Cross-Sectional Study in North West Ethiopia. J Healthc Eng [Internet]. 2018 [citado 03/07/2021];2018:2389268. Disponible en: https://www.hindawi.com/journals/jhe/2018/2389268/. https://doi.org/10.1155/2018/2389268
Rezaei P, Maserrat E, Torab-Miandoab A. Specialist Physicians’ Perspectives about Telemedicine and Barriers to Using it in Tabriz Teaching Hospitals. Iran South Med J [Internet]. 2018 [citado 03/07/2021];20(6):562-572. Disponible en: http://ismj.bpums.ac.ir/article-1-907-en.html
Curioso WH, Galán Rodas E. El rol de la telesalud en la lucha contra el COVID-19 y la evolución del marco normativo peruano. Acta Méd Peru [Internet]. 2020 [citado 03/07/2021];37(3):366-75. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172020000300366&lng=es. http://dx.doi.org/10.35663/amp.2020.373.1004
rpp.pe [Internet]. Perú: RPP; 2021 [actualizado 10/06/2021; citado 10/12/2021]. Telemedicina: Se pasó de 350 atenciones diarias a 22 mil durante la pandemia. Disponible en: https://rpp.pe/peru/actualidad/telemedicina-se-paso-de-350-atenciones-diarias-a-22-mil-durante-la-pandemia-noticia-1341516
América Economía [Internet]. Perú: América Economía; 2021 [actualizado 23/06/2021; citado 10/12/2021]. Yamakawa P. ¿Cómo cerrar la brecha digital en las zonas rurales de Perú?. Disponible en: https://www.americaeconomia.com/analisis-y-opinion/como-cerrar-la-brecha-digital-en-las-zonas-rurales-de-peru
Daniel H, Sulmasy LS, Health and Public Policy Committee of the American College of Physicians. Policy Recommendations to Guide the Use of Telemedicine in Primary Care Settings: An American College of Physicians Position Paper. Ann Intern Med [Internet]. 2015 [citado 03/07/2021];163(10):787-789. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26344925/. https://doi.org/10.7326/M15-0498
Monaghesh E, Hajizadeh A. The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence. BMC Public Health [Internet]. 2020 [citado 12/12/2021];20(1):1193. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7395209/. https://doi.org/10.1186/s12889-020-09301-4
Gajarawala SN, Pelkowski JN. Telehealth Benefits and Barriers. J Nurse Pract [Internet]. 2021 [citado 12/12/2021];17(2):218-221. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577680/. https://doi.org/10.1016/j.nurpra.2020.09.013
Fazal N, Webb A, Bangoura J, El Nasharty M. Telehealth: Improving maternity services by modern technology. BMJ Open Qual [Internet]. 2020 [citado 12/12/2021];9(4):e000895. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640525/. https://doi.org/10.1136/bmjoq-2019-000895
Ladin K, Porteny T, Perugini JM, Gonzales KM, Aufort KE, Levine SK, et al. Perceptions of Telehealth vs In-Person Visits among Older Adults with Advanced Kidney Disease, Care Partners, and Clinicians. JAMA Netw Open [Internet]. 2021 [citado 12/12/2021];4(12):e2137193. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649833/. https://doi.org/10.1001/jamanetworkopen.2021.37193
Serón P, Oliveros MJ, Fuentes-Aspe R, Gutiérrez-Arias R. Effectiveness of telerehabilitation in physical therapy: A protocol for an overview in a time when rapid responses are needed. Medwave [Internet]. 2020 [citado 12/12/2021];20(7):e7970. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32804923/. https://doi.org/10.5867/medwave.2020.07.7970
Pal T, Hull PC, Koyama T, Lammers P, Martinez D, McArthy J, et al. Enhancing Cancer care of rural dwellers through telehealth and engagement (ENCORE): protocol to evaluate effectiveness of a multi-level telehealth-based intervention to improve rural cancer care delivery. BMC Cancer [Internet]. 2021 [citado 08/01/2022];21:1262. Disponible en: https://bmccancer.biomedcentral.com/articles/10.1186/s12885-021-08949-4. https://doi.org/10.1186/s12885-021-08949-4
Martínez Pérez DC, García Cano JF, Vallejo Bocanumen CE. Ruta integral de atención en salud a través de la telesalud para el manejo del síndrome coronario agudo. Rev Colomb Cardiol [Internet]. 2021 [citado 08/01/2022];28(5):495-501. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0120-56332021000500495〈=pt. https://doi.org/10.24875/rccar.m21000090
Candido N, Marcolino A, de Santana J, Silva J, Silva M. Remote assistance in physical therapy during the COVID-19 pandemic: a reflection on the challenges and opportunities in the Brazilian context [Internet]. SciELO Preprints. 2021 [citado 08/01/2022]. Disponible en: https://preprints.scielo.org/index.php/scielo/preprint/view/2101. https://doi.org/10.1590/SciELOPreprints.2101
Sattar S, Kuperman R. Telehealth in pediatric epilepsy care: A rapid transition during the COVID-19 pandemic. Epilepsy Behav [Internet]. 2020 [citado 10/12/2021];111:107282. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386847/. https://doi.org/10.1016/j.yebeh.2020.107282
Grewal US, Shankar A, Saini D, Seth T, Roy S, Aden D, et al. Tele-health and cancer care in the era of COVID-19: New opportunities in low and middle income countries (LMICs). Cancer Treat Res Commun [Internet]. 2021 [citado 08/01/2022];27:100313. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7833952/. https://doi.org/10.1016/j.ctarc.2021.100313
Westhofen T, Magistro G, Lennartz S, Casuscelli J, Stief C, Rodler S. Confronting hidden COVID-19 burden: a telemedical solution for elective urological outpatient clinics. Infection [Internet]. 2020 [citado 10/12/2021];48(6):935-939. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7474800/. https://doi.org/10.1007/s15010-020-01511-7
Hewitt KC, Rodgin S, Loring DW, Pritchard AE, Jacobson LA. Transitioning to telehealth Neuropsychology service: considerations across adult and pediatric care settings. Clin Neuropsychol [Internet]. 2020 [citado 03/07/2021]:34(7-8):1335-1351. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32842849/. https://doi.org/10.1080/13854046.2020.1811891
Gomes Rodriguez DL, Silvestre Belber G, Valle De Queiroz Padilha F, Fonseca Spinel L, Moreira FR, Maeyama MA, et al. Impact of teleconsultation on patients with type 2 diabetes in the Brazilian Public Health Ssystem: protocol for a randomized controlled trial (TELEconsulta Diabetes Trial). JMIR Res Protoc [Internet]. 2021 [citado 10/12/2021];10(1):e23679. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861994/. https://doi.org/10.2196/23679
Damasceno RF, Caldeira AP. Fatores associados à não utilização da teleconsultoria por médicos da Estratégia Saúde da Família. Ciênc Saúde Coletiva [Internet]. 2019 [citado 03/07/2021];24(8):3089-3098. Disponible en: https://www.scielo.br/j/csc/a/MRRvhCdyhF3FpTcg4gkP3ns/#. https://doi.org/10.1590/1413-81232018248.28752017
Andrews E, Berghofer K, Long J, Prescott A, Caboral-Stevens M. Satisfaction with the use of telehealth during COVID-19: An integrative review. Int J Nurs Stud Adv [Internet]. 2020 [citado 10/12/2021];2:100008. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7564757/. https://doi.org/10.1016/j.ijnsa.2020.100008
Győrffy Z, Radó N, Mesko B. Digitally engaged physicians about the digital health transition. PLoS One [Internet]. 2020 [citado 12/12/2021];15(9):e0238658. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521720/. https://doi.org/10.1371/journal.pone.0238658
Fieux M, Duret S, Bawazeer N, Denoix L, Zaouche S, Tringali S. Telemedicine for ENT: Effect on quality of care during Covid-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis [Internet]. 2020 [citado 03/07/2021];137(4):257-261. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7306717/. https://doi.org/10.1016/j.anorl.2020.06.014
Vázquez FL, Torres A, Blanco V, Otero P, Hermida E. Intervenciones psicológicas administradas por teléfono para la depresión: una revisión sistemática y meta-análisis. Rev Iberoam Psicol Salud [Internet]. 2015 [citado 03/07/2021];6(1):39-52. Disponible en: https://www.elsevier.es/es-revista-revista-iberoamericana-psicologia-salud-152-articulo-intervenciones-psicologicas-administradas-por-telefono-S2171206915700050. https://doi.org/10.1016/S2171-2069(15)70005-0
McDaniel CC, Kavookjian J, Whitley HP. Telehealth delivery of motivational interviewing for diabetes management: A systematic review of randomized controlled trials. Patient Educ Couns [Internet]. 2022 [citado 02/04/2022;105(4):805-820. Disponible en: https://www.sciencedirect.com/science/article/pii/S0738399121004961. https://doi.org/10.1016/j.pec.2021.07.036
Alvandi M. Telemedicine and its Role in Revolutionizing Healthcare Delivery. Am J Accountable Care [Internet]. 2017 [citado 13/12/2021];5(1):e1-e5. Disponible en: https://www.ajmc.com/view/telemedicine-and-its-role-in-revolutionizing-healthcare-delivery
Siow MY, Walker JT, Britt E, Kozy JP, Zanzucchi A, Girard PJ, et al. What was the change in Telehealth Usage and proportion of no-show visits for an orthopaedic trauma clinic during the COVID-19 pandemic? Clin Orthop Relat Res [Internet]. 2020 [citado 12/12/2021];478(10):2257-2263. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491875/. https://doi.org/10.1097/CORR.0000000000001396
Serhal E, Kirvan A, Sanches M, Crawford A. Client satisfaction and experience with telepsychiatry: development and validation of a survey using clinical quality domains. J Med Internet Res [Internet]. 2020 [citado 03/07/2021];22(9):e19198. Disponible en: https://www.jmir.org/2020/9/e19198/. https://doi.org/10.2196/19198
Gilkey MB, Kong WY, Huang Q, Grabert BK, Thompson P, Brewer NT. Using Telehealth to Deliver Primary Care to Adolescents During and After the COVID-19 Pandemic: National Survey Study of US Primary Care Professionals. J Med Internet Res [Internet]. 2021 [citado 10/12/2021];23(9):e31240. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437399/. https://doi.org/10.2196/31240
Giachini Esmerio F, Goldmeier S, Costa Duarte Barbosa E, Marcelo Segredo L, Silva R, Irigoyen S, et al. Implementation of a Telecardiology Service in a Health Unit in the City of Porto Alegre, Brazil: A pilot study. Int J Cardiovasc Sci [Internet]. 2022 [citado 08/01/2022];35(2):152-158. Disponible en: https://www.scielo.br/j/ijcs/a/HP8dm3rqyk7R39dv8r9VbMq/?format=pdf〈=en. https://doi.org/10.36660/ijcs.20200305
Patel P, Dhindsa D, Eapen DJ, Khera A, Gulati M, Stone NJ, et al. Optimizing the Potential for Telehealth in Cardiovascular Care (in the Era of COVID-19): Time Will Tell. Am J Med [Internet]. 2021 [citado 03/07/2021];134(8):945-951. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553403/. https://doi.org/10.1016/j.amjmed.2021.03.007
Kirby DJ, Fried JW, Buchalter DB, Moses MJ, Hurly ET, Cardone DA, et al. Patient and Physician Satisfaction with Telehealth During the COVID-19 Pandemic: Sports Medicine Perspective. Telemed J E Health [Internet]. 2021 [citado 01/10/2021];27(10):1151-1159. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33512302/. https://doi.org/10.1089/tmj.2020.0387
Dobrusin A, Hawa F, Gladshteyn M, Corsello P, Harlen K, Walsh CX, et al. Gastroenterologists and Patients Report High Satisfaction Rates With Telehealth Services During the Novel Coronavirus 2019 Pandemic. Clin Gastroenterol Hepatol [Internet]. 2020 [citado 01/10/2021];18(11):2393-2397.e2. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352104/. https://doi.org/10.1016/j.cgh.2020.07.014
Eannucci EF, Hazel K, Grundstein MJ, Nguyen JT, Gallegro J. Patient Satisfaction for Telehealth Physical Therapy Services was Comparable to that of In-Person Services during the COVID-19 Pandemic. HSS J [Internet]. 2020 [citado 01/10/2021];16(Suppl 1):10-16. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571303/. https://doi.org/10.1007/s11420-020-09800-5
Buchalter DB, Moses MJ, Azad A, Kirby DJ, Huang S, Bosco III JA, et al. Patient and Surgeon Satisfaction with Telehealth During the COVID-19 Pandemic. Bull Hosp Jt Dis (2013) [Internet]. 2020 [citado 12/12/2021];78(4):227-235. Disponible en: https://pubmed.ncbi.nlm.nih.gov/33207143/
Isautier JMJ, Copp T, Ayre J, Cvejic E, Meyerowitz-Katz G, Batcup C, et al. People’s Experiences and Satisfaction With Telehealth During the COVID-19 Pandemic in Australia: Cross-Sectional Survey Study. J Med Internet Res [Internet]. 2020 [citado 10/12/2021];22(12):e24531. Disponible en: https://www.jmir.org/2020/12/e24531/. https://doi.org/10.2196/24531
Kemp MT, Liesman DR, Williams AM, Brown CS, Iancu AM, Wakam GK, et al. Surgery Provider Perceptions on Telehealth Visits During the COVID-19 Pandemic: Room for Improvement. J Surg Res [Internet]. 2021 [citado 03/07/2021];(260):300-306. Disponible en: https://www.journalofsurgicalresearch.com/article/S0022-4804(20)30777-0/fulltext. https://doi.org/10.1016/j.jss.2020.11.034
Richards AE, Curley K, Christel L, Zhang N, Kouloumberis P, Kalani MA, et al. Patient satisfaction with telehealth in neurosurgery outpatient clinic during COVID-19 pandemic. Interdiscip Neurosurg [Internet]. 2021 [citado 03/07/2021];23:101017. Disponible en: https://www.sciencedirect.com/science/article/pii/S2214751920305788. https://doi.org/10.1016/j.inat.2020.101017
Shafi K, Lovecchio F, Forston K, Wyss J, Casey E, Press J, et al. The Efficacy of Telehealth for the Treatment of Spinal Disorders: Patient-Reported Experiences during the COVID-19 Pandemic. HSS J [Internet]. 2020 [citado 12/12/2021];16(Suppl 1):17-23. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640578/. https://doi.org/10.1007/s11420-020-09808-x
Jeganathan S, Prasannan L, Blitz MJ, Vohra N, Rochelson B, Meirowitz N. Adherence and acceptability of telehealth appointments for high-risk obstetrical patients during the coronavirus disease 2019 pandemic. Am J Obstet Gynecol MFM [Internet]. 2020 [citado 12/12/2021];2(4):100233. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506329/. https://doi.org/10.1016/j.ajogmf.2020.100233
Bhatia R. Telehealth and COVID-19: Using technology to accelerate the curve on access and quality healthcare for citizens in India. Technol Soc [Internet]. 2021 [citado 12/12/2021];64:101465. Disponible en: https://www.sciencedirect.com/science/article/pii/S0160791X20312689. https://doi.org/10.1016/j.techsoc.2020.101465
Verhoeven F, Tanja-Dijkstra K, Nijland N, Eysenbach G, van Gemert-Pijnen L. Asynchronous and synchronous teleconsultation for diabetes care: a systematic literature review. J Diabetes Sci Technol [Internet]. 2010 [citado 12/12/2021];4(3):666-84. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901046/. https://doi.org/10.1177/193229681000400323
Enlaces refback
Copyright (c) 2023 Roberto Pelayo Mosqueira Moreno, Araceli del Milagro Gonzáléz Castillo, Flor Delicia Heredia Llatas