Impact of a large-scale telemedicine network on emergency visits and hospital admissions during the coronavirus disease 2019 pandemic in Brazil: Data from the UNIMED-BH system.
J Telemed Telecare
; : 1357633X20969529, 2020 Oct 25.
Article
in English
| MEDLINE | ID: covidwho-2233679
ABSTRACT
INTRODUCTION:
Triage by on-demand telemedicine is a strategy for healthcare surge control in the COVID-19 pandemic. We aimed to assess the impact of a large-scale COVID-19 telemedicine system on emergency department (ED) visits and all-cause and cardiovascular hospital admissions in Brazil.METHODS:
From March 18-May 18, 2020 we evaluated the database of a cooperative private health insurance, with 1.28 million clients. The COVID-19 telemedicine system consisted of a) mobile app, which redirects to teleconsultations if indicated; b) telemonitoring system, with regular phone calls to suspected/confirmed COVID-19 cases to monitor progression; c) emergency ambulance system (EAS), with internet phone triage and counselling. ED visits and hospital admissions were recorded, with diagnoses assessed by the Diagnosis Related Groups method. COVID-19 diagnosis and deaths were identified from the patients' registries, and outcomes assessed until June 1st.RESULTS:
In 60 days, 24,354 patients accessed one of the telemedicine systems. The most frequently utilized was telemonitoring (16,717, 69%), followed by teleconsultation (13,357, 55%) and EAS (687, 3%). The rates of ED and hospital admissions were telemonitoring 19.7% (3,296) and 4.7% (782); teleconsultation 17.3% (2,313) and 2.4% (318) and EAS 55.9% (384) and 56.5% (388) patients. At total 4.1% (1,010) had hospital admissions, 36% (363) with respiratory diseases (44 requiring mechanical ventilation) and 4.4% (44) with cardiovascular diagnoses. Overall, 277 (1.1%) patients had confirmed COVID-19 diagnosis, and 160 (0.7%) died, 9 with COVID-19.CONCLUSION:
Telemedicine resulted in low rates of ED visits and hospital admissions, suggesting positive impacts on healthcare utilization. Cardiovascular admissions were remarkably rare.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Observational study
/
Randomized controlled trials
Country/Region as subject:
South America
/
Brazil
Language:
English
Journal:
J Telemed Telecare
Journal subject:
Medical Informatics
/
Health Services
Year:
2020
Document Type:
Article
Affiliation country:
1357633X20969529
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