Abstract
A telecardiology remote cardiology medical care system was implemented in 82 municipalities of Minas Gerais State, Brazil to support basic network services in the early diagnosis and management of cardiovascular diseases. To investigate the factors associated with the implementation of this program in the municipalities. This 2006 ecological study involved 393 candidate municipalities to implement the system. The municipalities were divided into two groups: non-random intervention (n = 82) and comparative (n = 311). The social, structure, healthcare needs, and governability indexes of the two groups of municipalities were compared by descriptive and multiple regression analysis using the generalized estimation equation model. After fitting for other characteristics, participation of the municipalities in the intervention was associated with a higher social responsibility index (OR: 2.44, CI: 1.50-3.96) and lower healthcare needs (OR: 2.29, CI: 1.24-4.22). Greater efforts by municipality management was the key to attracting and implementing the remote cardiology intervention, even when fitted for lower healthcare needs, which suggests greater municipal political and social engagement. This translated to improved access to cardiovascular health care for Brazilian rural and remote populations in the intervention municipalities.
Highlights
A telecardiology remote cardiology medical care system was implemented in 82 municipalities of Minas Gerais State, Brazil to support basic network services in the early diagnosis and management of cardiovascular diseases
Given the non-random assignment of interventions in the implementation of the Minas Telecardio Project, the purpose of this article was to look at factors beyond ‘health’ associated with the selection of municipalities to implement a telecardiology remote medical care system
The remote cardiology medical care system was implemented in Minas Gerais State municipalities according to the following two initial inclusion criteria: greater than 70% coverage by the family health care program[11]; and a population of 10 500 or fewer[6]
Summary
A telecardiology remote cardiology medical care system was implemented in 82 municipalities of Minas Gerais State, Brazil to support basic network services in the early diagnosis and management of cardiovascular diseases. Conclusion: Greater efforts by municipality management was the key to attracting and implementing the remote cardiology intervention, even when fitted for lower healthcare needs, which suggests greater municipal political and social engagement This translated to improved access to cardiovascular health care for Brazilian rural and remote populations in the intervention municipalities. While the use of telecommunications systems can be a viable and valuable strategy for overcoming geopolitical barriers in remote medical care[3,4], such health technology is rarely available in Brazil In this context, the Minas Telecardio project was established in Brazil’s Minas Gerais State in June 2006, with an aim to support the basic healthcare network in early diagnosis and management of those with cardiovascular disease. The project was implemented in 82 small municipalities in partnership with the State Health Secretary and five state universities[5]
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