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[This corrects the article DOI: 10.2196/52946.].
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Background: The outbreak of COVID-19 has turned the care model of health systems around the world upside down. The health care crisis has led to opportunities for digital health to deliver quality care, and the system has been redirected toward telemedicine. In Catalonia, Spain, as of March 2020, the pattern of visits in primary care pediatric consultations changed, such that face-to-face visits decreased in favor of non-face-to-face visits. Objective: This study aimed to analyze variations in the types of pediatric visits in primary care centers in Catalonia before and after the onset of COVID-19. Methods: This was a descriptive observational study based on administrative data. The number and type of visits to primary care pediatric services in Catalonia between January 2019 and December 2022 were studied. Results: A drop of more than 80% in face-to-face visits and an increase of up to 15 times in remote visits were observed as of March 2020 compared to the previous year. Subsequently, the face-to-face attendance rate began to recover, although it did not reach the same rate as before COVID-19. Non-face-to-face visits were maintained, representing more than 20% of the total after more than 2 years of the pandemic. Conclusions: COVID-19 has been the trigger for a transition in the types of visits to primary care pediatric services. The COVID-19 pandemic was a clear catalyst for the integration of telemedicine in Catalan pediatric health care. In this context, although face-to-face consultations have recovered in absolute numbers, after the pandemic period, the weight of telemedicine has increased.
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BACKGROUND: For years, in Catalonia and in the rest of Spain, there has been a deficit and an unequal geographical distribution of health professionals specializing in pediatrics, especially in rural areas. Among the proposals to improve this situation is the promotion of the use of information and communication technologies (ICT) among users and professionals. Moreover, with the outbreak of COVID-19, the use of telehealth has become an essential tool, with an overall increase in non-face-to-face visits, including in primary care pediatrics. In this context, telemedicine, when used in primary care pediatrics, can be an effective means of improving families' access to medical care. Currently, in Catalonia, telemedicine involving patients and health professionals is used in pediatric primary care through telephone consultation and asynchronous teleconsultation (eConsulta). Video consultation is in practice not used, although it could have different applications. OBJECTIVE: The aim of this study is to evaluate the feasibility of a video consultation process with physical examination in acute pediatric pathology in rural areas among primary care professionals. In addition, the level of satisfaction with these remote consultations will be assessed from the perspective of both the users and the health care professionals. METHODS: We will conduct a prospective experimental study to analyze the possibility of using video consultation in pediatric acute care in primary care in central Catalonia (Spain). A minimum of 170 children aged between 0 and 14 years attending the primary care center (PCC) for acute illness for a period of 1 year will be included in the study. Initially, the telemetric visit, including a physical examination, will include a nurse at the patient and family's side and a pediatrician who will participate remotely. Subsequently, the pediatrician will visit the patient in person and the physical examination and diagnosis made during the remote visit will be compared with the physical examination and diagnosis of the face-to-face visit, which is considered the gold standard. RESULTS: Recruitment was planned to begin in the second half of 2023 and continue for at least 1 year. It is anticipated to be a good resource for a variety of acute pediatric conditions in primary care. The evaluation will focus on the feasibility of performing live remote visits and comparing their diagnostic accuracy with that of face-to-face visits. CONCLUSIONS: We believe that this study could provide evidence on the feasibility and diagnostic accuracy of video consultation in pediatric acute primary care in a rural setting, as well as on satisfaction with video consultations among both users and professionals. If proven useful in addressing the acute needs of children in a variety of situations, it could become a digital health tool that improves the overall pediatric primary care service in rural areas, for both families and professionals. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52946.
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La cistinuria es una enfermedad genética que provoca un defecto de reabsorción de cistina, causando como manifestación principal litiasis urinarias que pueden llegar a ser de gran tamaño. Es importante tratarla desde temprana edad porque puede comportar importantes comorbilidades. (AU)
Cystinuria is a genetic disease that causes impaired cystine reabsorption. Its main manifestation is urolithiasis, in some cases producing very large stones. It is important to treat it from an early age because it can lead to important comorbidities. (AU)
