Analisando o uso e a qualidade dos serviços de telessaúde na atenção primária: o caso de Minas Gerais

Abstract

The use of information and communication technologies is increasingly present in the healthcare industry to support and transmit information over long or short distances. Telemedicine is seen as an important tool for addressing these contemporary health challenges. However, although Telehealth actions have proven to be favorable to health actions, it is necessary to recognize that there are additional risks to the quality of health care offered at a distance. For this reason, it is necessary to continue studying not only the quantitative results on the expansion of access to consultations and diagnostics via telemedicine, but also to unveil questions that favor the use of this resource at different levels of care, so that they can be established. indicators of structure, processes and results that effectively assist in the evaluation and construction of the quality of these services. OBJECTIVE: To evaluate the use and quality of telehealth services offered in Minas Gerais, based on ISO 13131 regulations, which provide for quality parameters in telehealth services. METHODOLOGY: This is an analytical cross-sectional study with a quantitative approach for the municipalities that use the telehealth resource in the state of Minas Gerais, consisting of three stages. The first of these is to identify the municipalities of the state that use telehealth; In the second stage, a questionnaire on the quality of telehealth health services based on ISO 13131 was developed and applied from a stratified sample. In the third stage were constituted levels of quality in telehealth from the collected data; For the quality of care levels, the data obtained from the PMAQ 2nd cycle held in 2014 were used. In this stage, we sought to identify whether the quality of the provision of telehealth services is related to a better result of the quality of health care in health care. using logistic regression. RESULTS: It was identified that of the 853 municipalities of Minas Gerais, 548 (64%) have records of telehealth activities. In the stratification of the level of resource use, it was identified that, of the 548 municipalities, 11% (59) have low utilization, 66% (360) have medium usage and 24% (129) were identified as high. utilization rate. Based on this identified sample, a questionnaire to evaluate the quality of telehealth services was structured and applied according to ISO13131 parameters, which indicated that 186 (51%) of the municipalities have high quality in telehealth; 136 (37%) have medium quality and 44 (12%) have poor quality. After that, an association analysis was performed between the quality in telehealth and the quality of care. It was identified that there was no association between quality of care and quality of care. From the various dimensions related to the quality of telehealth, it is noted that the dimension Quality and Risk Management was associated with the quality of care. CONCLUSION: The questionnaire presented itself as a consistent tool. Most of the participating municipalities obtained high quality in telehealth and the Quality and Risk Management dimension was associated with the quality of care.