[The analysis of visits for telemedicine consultations in the National Medical Research Center of Children Health during three-years period]

The purpose of the study was to analyze functioning of the Department of telemedicine department over three-year period with assessment of main trends and regional characteristics, as well as the most significant results of telemedicine consultations. The step-wise analysis of applications for telemedicine consultation in 2019-2021 was carried out. They were conventionally classified by "in-coming" and "out-coming" information. At the first stage, number of applications received in 2019-2021 (n=10,145) was analyzed. The regional features of applications were established. At the second stage, extended analysis of all applications received in 2021 (n=4518) was carried out considering type of request, profile of request, fact of video communication, structure of directional diagnoses according the ICD-10 classes with identification of regional characteristics. At the third stage, sampling analysis of applications in 2021 (n=1000) was carried out with in-depth assessment of "in-coming" and "out-coming" information. The study established trend of annual increase of number of requests for telemedicine care (2,380 in 2019; 3,237 in 2020; 4,518 in 2021). The Privolzhsky Federal Okrug is leading in number of applications. The neurologists, rheumatologists and gastroenterologists are the most called-for specialists of somatic profile. The thoracic, neonatal and abdominal surgeons are the most-called specialists of surgical profile. This structure corresponded in whole to the structure of the ICD-10 classes that the region requested. The analysis of consultations testified high need in hospitals to transfer children to the Federal Center for treatment (57.6% of applications), that was not always justified. Therefore, positive decision about hospitalization was made less often (35% of cases). The recommendations of specialists of the National Medical Research Center for Children Health concerning treatment tactics (46% of applications) and additional examinations (44% of applications) were provided more often than it was indicated in application. The conclusion was made about increasing demand for and importance of telemedicine consultations in format "physician-physician" in pediatric practice and necessity of further research study with purpose to improve and optimize this type of medical care.