Dados do Trabalho

Título

Teleconsultations in neurology developed and implemented during the COVID-19 pandemic in the Brazilian universal health system.

Resumo

Background: Teleconsultation gain strength in Brazil as an urgent response to the COVID-19 pandemic, aiming at providing alternative strategies of care in a context of overburdened health systems. Ever since Brazil’s Unified Health System (Sistema Único de Saúde, SUS) conception, primary health care (PHC) was designed to be the main form of access to the health services, to facilitate a structured and coordinated care. Despite these efforts, there are still important gaps between primary and specialized care due to the fragmentation of healthcare networks and to the expressive demand for consultations in secondary and tertiary care, ultimately resulting in long waiting lists for many medical specialties, including neurology. In 2018, the Ministry of Health of Brazil started a project in partnership with private hospitals aiming to improve efficiency in referring cases from PHC to specialized care, employing telehealth strategies. To minimize the impact of the pandemic on the access of patients to specialized care, the project expanded its activities by initiating the offer of teleconsultations.

Objective: The aim of this study is to characterize the teleconsultations in neurology carried out by this project in Recife, capital of Pernambuco, a state in northeastern Brazil.

Methods: Retrospective study evaluating teleconsultations in neurology that happened between May to September 2020. Teleconsultation was performed preferably in the video modality. Conditions eligible for teleconsultation were headache, epilepsy, and cerebrovascular disorders.

Results: A total of 243 teleconsultations were analyzed, of which 76.95% was a first appointment. In 48.97% of cases, the teleconsultation represented the first opportunity for the patient to be consulted with the specialist. Among cases of first appointment, 20.16% were further referred to a face-to-face consultation and 21.81% could be redirected to primary health care. Headache disorders were the most predominant clinical conditions.

Conclusions: The implementation and development of telemedicine in neurology during the Covid-19 pandemic represented an opportunity to assess the value of having teleconsultations added along the line of care from primary care to a medical specialty, promoting the coordination of care across different levels of complexity of care in the health system and improving access to specialized care.

Palavras Chave

Telemedicine, Remote consultation, Neurology, COVID-19