[Telehealth: a digital strategy for demand management in primary health care facilities in ChileTelessaúde: uma estratégia digital para a gestão da demanda na atenção primária à saúde no Chile].

Abstract

Objective: Describe and examine the use of the digital telehealth strategy in primary health care (PHC) facilities in Chile, describe its implementation in the country, and analyze its impact on demand management within the Chilean health system.

Methods: A cross-sectional descriptive observational study was conducted in 320 PHC facilities in the telehealth system. All requests for care registered on the platform were analyzed using anonymized data from the panel of telehealth indicators. Studied variables included: volume of requests, distribution by sex and age, variability in demand, percentage of requests resolved remotely, and waiting times according to clinical priority level. A descriptive analysis of frequencies and proportions was performed, and an estimate was made of the impact of telehealth in terms of reducing in-person visits.

Results: Between January 2021 and December 2024, 5 037 145 requests from 1 292 942 individuals were received on the telehealth platform, with a higher participation of women (64.4%). The predominant age group was 25 to 65 years (49.8%). Demand was highest in October and November; February and December were the least active months. A total of 23.45% of users enrolled in PHC used telehealth services at least once. Of the total number of requests, 28.4% were handled remotely, 62.7% required in-person attention, and 6.4% were closed for administrative reasons. Waiting times for high-priority requests averaged eight days, which is above the recommended standard of 24 to 48 hours.

Conclusions: Telehealth has proven to be an effective strategy for demand management in PHC, with high adoption among working-age adults. However, challenges remain in terms of managing high-priority requests and ensuring equity of digital access for older adults. It is recommended to strengthen the integration of high-quality telemedicine services and to improve response times based on clinical urgency in order to optimize the strategy's impact on access to health care.