Gender differences on healthcare accessibility and outcomes of a electronic inter‐clinician consultation program at the cardiology department in a Galician Health Area

Aims To assess the longer‐term results (hospital admissions and mortality) in women versus men referred to a cardiology department from primary care using an e‐consultation in our outpatient care programme. Methods We selected 61,306 patients (30,312 women and 30,994 men) who visited the cardiology...

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Published in:European journal of clinical investigation 2023-09, Vol.53 (9), p.e14012-n/a
Main Authors: Mazón‐Ramos, Pilar, Rey‐Aldana, Daniel, Garcia‐Vega, David, Portela‐Romero, Manuel, Rodríguez‐Mañero, Moisés, Lage‐Fernández, Ricardo, Cinza‐Sanjurjo, Sergio, González‐Juanatey, José R.
Format: Article
Language:English
Subjects:
Cardiology
cardiovascular outcomes
Congestive heart failure
Gender
Gender aspects
Gender differences
Health care
Hospitals
Impact analysis
inter‐clinician electronic consultation
Men
Mortality
Patient admissions
Patients
Primary care
Regression models
Sex differences
Women
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Summary:Aims To assess the longer‐term results (hospital admissions and mortality) in women versus men referred to a cardiology department from primary care using an e‐consultation in our outpatient care programme. Methods We selected 61,306 patients (30,312 women and 30,994 men) who visited the cardiology service at least once between 2010 and 2021: 69.1% (19,997 women and 20,462 men) were attended in e‐consultation (from 2013 to 2021) and 30.9% (8920 women and 9136 men) in in‐person consultations (from 2010 to 2012) without gender differences in the proportion of patients attended in each period. Using an interrupted time series regression model, we analysed the impact of incorporating e‐consultation into the healthcare model and evaluated the elapsed time to cardiology care, heart failure (HF), cardiovascular (CV), and all‐cause hospital admissions and mortality during the one‐year after cardiology consultation. Results The introduction of e‐consultation substantially decreased waiting times to cardiology care; during the in‐person consultation period, the mean delay for cardiology care was 57.9 (24.8) days in men and 55.8 (22.8) days in women. During the e‐consultation period, the waiting time to cardiology care was markedly reduced to 9.41 (4.02) days in men and 9.46 (4.18) in women. After e‐consultation implantation, there was a significant reduction in the 1‐year rate of hospital admissions and mortality, both in women and men iRR [IC 95%]: 0.95 [0.93–0.96] for HF, 0.90 [0.89–0.91] for CV and 0.70 [0.69–0.71] for all‐cause hospitalization; and 0.93 [0.92–0.95] for HF, 0.86 [0.86–0.87] for CV and 0.88 [0.87–0.89] for all‐cause mortality in women; and 0.91 [0.89–0.92] for HF, 0.90 [0.89–0.91] for CV and 0.72 [0.71–0.73] for all‐cause hospitalization; and 0.96 [0.93–0.97] for HF, 0.87 [95% CI: 0.86–0.87] for CV and 0.87 [0.86–0.87] for all‐cause mortality, in men. Conclusion Compared with the in‐person consultation period, an outpatient care programme that includes an e‐consultation significantly reduced waiting time to cardiology care and was safe, with a lower rate of hospital admissions and mortality in the first year, without significative gender differences. Clinician‐to‐clinician electronic consultation programmes (characterized by asynchronous communication between healthcare professionals) has the main objective reducing the excessive waiting times to obtain a specialist consultant's expert opinion. We analyse our e‐consult model that includes 61,306 p
ISSN:0014-2972
1365-2362
DOI:10.1111/eci.14012