Advances in rehabilitation science and practice · 2025
Telemedicine Challenges in Latin-America: Outcomes from Telerehabilitation Services During the COVID-19 Pandemic in Cali, Colombia-A Retrospective Cohort Study.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Pacichana-Quinayaz Sara Gabriela, Rodríguez Vélez Lina María, Sánchez Cano Daniel, Hernández Orobio Olga Marina, Tovar Sánchez María Ana, Toro Córdoba Gloria Isabel, Bonilla-Escobar Francisco Javier
Аннотация
PURPOSE: The COVID-19 pandemic disrupted in-person healthcare and accelerated the adoption of telemedicine, for which most low- and middle-income countries were unprepared. This study describes the population, service delivery, and therapeutic outcomes of telerehabilitation in Cali, Colombia, during the pandemic, and identifies factors influencing its feasibility to guide future implementation in similar low-resource settings.
METHODS: We conducted a retrospective cohort study using medical records from 2 rehabilitation centers in Cali, Colombia, including patients who received synchronous telerehabilitation between January 2020 and December 2021. Data on demographics, diagnoses (grouped as mental health, neurological, chronic, post-traumatic, or unspecified), and outcomes (recovery, dropout, continued care) were collected using a structured form and analyzed with descriptive statistics and non-parametric tests (Wilcoxon, Kruskal-Wallis, chi-square, or Fisher's exact), with significance set at p < .05.
RESULTS: We analyzed 1572 patients receiving telerehabilitation. Most were women (65.4%), aged 36 to 64 (46.5%), with trauma sequelae (32.8%) and mental health conditions (26.3%) as common diagnoses. Main services were physiatry (32%), psychosocial therapy (29%), and physiotherapy (27%). Most sessions were by phone (67.5%) and completed successfully (90%). Recovery was reported in 6.4% of cases; 13.3% completed treatment, 72.3% required ongoing care, and 3% dropped out. Completion was more common in older patients (p < .05).
CONCLUSIONS: The COVID-19 pandemic underscored telerehabilitation's vital role in Latin America, revealing access gaps and the need for further research to address socioeconomic, educational, and digital barriers affecting vulnerable populations. The patterns of telerehabilitation utilization varied notably by age, sex, and diagnosis, highlighting the necessity of strengthening and adapting these services to improve health outcomes and ensure equitable access. Gaps remain in areas of telerehabilitation such as, mental health, cardiovascular diseases and ophthalmology, underscoring the need for broader implementation and integration across specialties.
METHODS: We conducted a retrospective cohort study using medical records from 2 rehabilitation centers in Cali, Colombia, including patients who received synchronous telerehabilitation between January 2020 and December 2021. Data on demographics, diagnoses (grouped as mental health, neurological, chronic, post-traumatic, or unspecified), and outcomes (recovery, dropout, continued care) were collected using a structured form and analyzed with descriptive statistics and non-parametric tests (Wilcoxon, Kruskal-Wallis, chi-square, or Fisher's exact), with significance set at p < .05.
RESULTS: We analyzed 1572 patients receiving telerehabilitation. Most were women (65.4%), aged 36 to 64 (46.5%), with trauma sequelae (32.8%) and mental health conditions (26.3%) as common diagnoses. Main services were physiatry (32%), psychosocial therapy (29%), and physiotherapy (27%). Most sessions were by phone (67.5%) and completed successfully (90%). Recovery was reported in 6.4% of cases; 13.3% completed treatment, 72.3% required ongoing care, and 3% dropped out. Completion was more common in older patients (p < .05).
CONCLUSIONS: The COVID-19 pandemic underscored telerehabilitation's vital role in Latin America, revealing access gaps and the need for further research to address socioeconomic, educational, and digital barriers affecting vulnerable populations. The patterns of telerehabilitation utilization varied notably by age, sex, and diagnosis, highlighting the necessity of strengthening and adapting these services to improve health outcomes and ensure equitable access. Gaps remain in areas of telerehabilitation such as, mental health, cardiovascular diseases and ophthalmology, underscoring the need for broader implementation and integration across specialties.