Rural-urban differences in the pattern of referrals to an asynchronous teledermatology service

Abstract
Background Telemedicine is particularly useful in rural areas where can facilitate access to specialised care in regions far from urban hospitals and can prevent unnecessary travel. The purpose of this research was to evaluate the degree of resolution of an asynchronous teledermatology service in the Bages County, comparing urban and rural primary care centres. Methods and findings A longitudinal descriptive study of referrals from 14 Primary Care Teams to a hospital dermatology service as a result of a previous referral to a teledermatology program was performed, comparing years 2015 and 2016 and urban with rural practices. Both in urban and rural areas there was an increase in referrals to the teledermatology service in 2016 compared to the previous year (12.9% and 0.3% respectively). In the two years analysed, referral rates to the teledermatology service per thousand inhabitants from rural centres was statistically much higher than that of urban centres (p