TY - JOUR
AU - Parker, Ruth
AU - Figures, Emma
AU - Paddison, Charlotte
AU - Matheson, James
AU - Blane, David N.
AU - Ford, John
PY - 2021
DA - April
TI - Inequalities in general practice remote consultations: a systematic review
JO - BJGP Open
DO - https://doi.org/10.3399/BJGPO.2021.0040
AB - Background: COVID-19 has led to rapid and widespread use of remote consultations in general practice, but the health inequalities impact remains unknown. Aim: To explore the impact of remote consultations in general practice compared to face-to-face consultations on utilisation and clinical outcomes across socio-economic and disadvantaged groups. Design &amp; setting: Systematic review Method: We undertook an electronic search of MEDLINE, EMBASE and Web of Science from inception to June 2020. We included studies which compared remote consultations to face-to-face consultations in primary care and reported outcomes by PROGRESS Plus criteria. Risk of bias was assessed using ROBINS-I. Data was synthesised narratively. Results: Based on 13 studies, exploring telephone and internet-based consultations, we found that telephone consultations were used by younger working age people, the very old and non-immigrants, with internet-based consultations more likely to be used by younger people. Women consistently used more remote forms of consulting than men. Socio-economic and ethnicity findings were mixed, with weak evidence that patients from more affluent areas were more likely to use internet-based communication. Remote consultations appeared to help patients with opioid dependence remain engaged with primary care. No studies reported on the impact on quality of care or clinical outcomes. Conclusion: Remote consultations in general practice are likely to be used more by younger working people, non-immigrants, the elderly and women, with internet-based consultations more by younger, affluent and educated groups. Wide-spread use of remote consultations should be treated with caution until the inequalities impact on clinical outcomes and quality of care is known.
PB - Royal College of General Practitioners
UR - http://eprints.gla.ac.uk/237595/
KW - Coronavirus (COVID-19)
KW - Health inequalities
KW - Primary care
ER