Email updates

Keep up to date with the latest news and content from BMC Health Services Research and BioMed Central.

Open Access Highly Accessed Research article

Teleconsultation service to improve healthcare in rural areas: acceptance, organizational impact and appropriateness

Paolo Zanaboni1*, Simonetta Scalvini2, Palmira Bernocchi2, Gabriella Borghi3, Caterina Tridico4 and Cristina Masella1

Author Affiliations

1 Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Milano, Italy

2 Salvatore Maugeri Foundation, IRCCS, Telemedicine Service, Lumezzane (Brescia), Italy

3 Cefriel, Milano, Italy

4 Lombardy Region - Health Care Directorate, Milano, Italy

For all author emails, please log on.

BMC Health Services Research 2009, 9:238  doi:10.1186/1472-6963-9-238

Published: 18 December 2009

Abstract

Background

Nowadays, new organisational strategies should be indentified to improve primary care and its link with secondary care in terms of efficacy and timeliness of interventions thus preventing unnecessary hospital accesses and costs saving for the health system. The purpose of this study is to assess the effects of the use of teleconsultation by general practitioners in rural areas.

Methods

General practitioners were provided with a teleconsultation service from 2006 to 2008 to obtain a second opinion for cardiac, dermatological and diabetic problems. Access, acceptance, organisational impact, effectiveness and economics data were collected. Clinical and access data were systematically entered in a database while acceptance and organisational data were evaluated through ad hoc questionnaires.

Results

There were 957 teleconsultation contacts which resulted in access to health care services for 812 symptomatic patients living in 30 rural communities. Through the teleconsultation service, 48 general practitioners improved the appropriateness of primary care and the integration with secondary care. In fact, the level of concordance between intentions and consultations for cardiac problems was equal to 9%, in 86% of the cases the service entailed a saving of resources and in 5% of the cases, it improved the timeliness. 95% of the GPs considered the overall quality positively. For a future routine use of this service, trust in specialists, duration and workload of teleconsultations and reimbursement should be taken into account.

Conclusions

Managerial and policy implications emerged mainly related to the support to GPs in the provision of high quality primary care and decision-making processes in promoting similar services.