Structure and working process to implement medical teleconsultation in the Unified Health System in Brazil, a cross sectional study using data from 2017-2018

Abstract

Objective: To compare structure and working process at primary care to implement medical teleconsultation in municipalities of different regions and population sizes (thousand inhabitants: <25; 25-100; >100). Methods: Cross-sectional study, with descriptive and bivariate analysis, using data from 2017-2018 to assess the availability of a computer with internet access, webcam, microphone, speaker and teams working processes (telehealth use, and existence of central regulation and communication between the teams). Results: 30,346 health units and 38,865 teams were evaluated. The presence of teleconsultation equipment in the units ranged from 1.2% in large northern municipalities to 26.7% in small southern municipalities. The working process to implement teleconsultation ranged from 10.7% in small northern municipalities to 39.5% in large southern municipalities. Compared to the South, medium municipalities in the North (OR=0.14 – CI_95% 0.11;0.17) and Northeast (OR=0.21 – CI_95% 0.18;0.25) regions were less likely to have necessary equipment. Conclusion: Investments in Digital Health are needed, with significant regional inequalities.