Characteristics of citizens and their use of teleconsultation in Primary Care in the Catalan public health system before and during COVID: Retrospective Descriptive Cross-Sectional Study.

BACKGROUND eConsulta (asynchronous and two-way teleconsultation in Primary Care) is one of the most important telemedicine developments in the Catalan public health system, a service that has been heavily boosted by the outbreak of the pandemic. It is vitally important to know the characteristics of its users in order to be able to meet their needs and have an idea of who is being covered (and who is not) through this service in a context where there is less accessibility to the health system. OBJECTIVE To analyze the profile of the citizens who use the tool and the type of use they make. To gain an understanding of the elements that characterize their decision to use it making a distinction between those who used it before and those who have used it since the outbreak of the COVID-19 pandemic. METHODS A descriptive observational study based on administrative data was performed. The study differentiates between the pandemic era and the period preceding to it, taking as the cut-off point the day the state of emergency was declared in Spain (13 March 2020), and between users who send messages and those who only receive them. The main study variable is the use of the eConsulta service. RESULTS The pandemic has resulted in almost triple the number of unique users of the teleconsultation service in just the first three months observed up to to 33.10 visits per 1000 inhabitants and month. . Since the start of the COVID outbreak, although users have continued to be predominantly female, they are systematically younger, more actively employed and with less complex pathologies for the two user profiles analysed. Users receive more messages proactively from the health professionals through eConsulta. There is also a relative decrease in the number of conversations initiated by higher-income urban citizens and an increment in users in rural areas. CONCLUSIONS The pandemic has helped to generalize the use of telemedicine as a tool to compensate to some extent for the decline in face-to-face visits, especially in younger citizen profiles. Telemedicine has made it possible to maintain contact between the citizen and the healthcare system in a context of maximum complexity. CLINICALTRIAL