RESUMEN
BACKGROUND: Real-time interactive teleconference clinical consultations are envisioned for increasing accessibility to medical care by patients whose demographics restrict care. There are no published studies, however, describing referrals and the referring practitioners, patients, and specialists participating in these consultations. OBJECTIVE: To assess characteristics of participants of interactive teleconference clinical consultations. DESIGN: Descriptive study, February 1, 1996, through April 30, 1999. SETTING: Eastern North Carolina: Brody School of Medicine at East Carolina University and 7 rural hospitals and clinics in its telemedicine network. SUBJECTS: Rural practitioners requesting consultations (n = 76), consulting physicians (n = 40), and patients completing evaluations following consultations (n = 495). MAIN OUTCOME MEASURES: Demographic and descriptive variables for referring providers, patients, and consulting physicians relative to the population in the region and to patients and physicians at the East Carolina University School of Medicine clinics. RESULTS: The largest number of referrals (65.2%) were made to obtain a second opinion or recommend a management plan in dermatology (33.5%), allergy (21.0%), or cardiology (17.8%). Significant patient characteristics were race (56.8% minorities), age (19.6% < or = 10 years old and 26.0% > or = 59.0 years old), sex (59% females), and insurance status (10.7% no insurance, 33.7% Medicaid, 15.4% Medicare). In addition, 38.0% had household incomes below the poverty level. Only 5.2% of the patients would have been treated by the referral practitioner, making travel necessary for consultation. Demographic characteristics of the practitioners were not statistically different. CONCLUSIONS: Participants of interactive teleconference clinical consultations are patients whose access to medical care might otherwise be limited. Use of telemedicine by practitioners is not related to age or sex. Arch Fam Med. 2000;9:1036-1040