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Inequalities in general practice remote consultations: a systematic review.

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Remote consultations in general practice are more likely to be used by younger, working individuals, non-immigrants, and women. Caution is advised until the impact on health inequalities and clinical outcomes is understood.

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Area of Science:

  • General practice and primary care research.
  • Health services research.
  • Digital health and telemedicine.

Background:

  • The COVID-19 pandemic accelerated the adoption of remote consultations in general practice.
  • The impact of these remote consultations on health inequalities remains largely unknown.
  • Understanding differential utilization is crucial for equitable healthcare delivery.

Purpose of the Study:

  • To compare the utilization and clinical outcomes of remote versus face-to-face consultations in primary care.
  • To examine the impact across various socioeconomic and disadvantaged groups.
  • To identify potential disparities in access and outcomes related to remote consultation modalities.

Main Methods:

  • A systematic review of electronic databases (MEDLINE, EMBASE, Web of Science) was conducted.
  • Included studies compared remote (telephone, internet) with face-to-face consultations in primary care.
  • Outcomes were assessed using PROGRESS Plus criteria, with risk of bias evaluated by ROBINS-I. Data synthesis was narrative.

Main Results:

  • Thirteen studies indicated telephone consultations were used by younger, working-age individuals, the very old, and non-immigrants.
  • Internet-based consultations were more common among younger individuals, with some evidence suggesting higher use in affluent areas.
  • Women consistently used remote consultations more than men; impacts on quality of care or clinical outcomes were not reported.

Conclusions:

  • Remote consultations in general practice are predominantly used by younger, working individuals, non-immigrants, older patients, and women.
  • Internet-based options appear more utilized by younger, affluent, and educated populations.
  • Further research is essential to understand the health inequalities associated with remote consultations and their impact on clinical outcomes and quality of care before widespread implementation.