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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

EV0423

Seven years of structured psychiatric expert assessments in a pension system: telemedicine expanded access without relaxing assessment criteria

SEVEN YEARS OF STRUCTURED PSYCHIATRIC EXPERT EVALUATION IN A PENSION SYSTEM: TELEMEDICINE MULTIPLIED ACCESS WITHOUT RELAXING EXPERT CRITERIA

Remote expert assessments increased the number of regions served eightfold, with no significant change in the proportion of favorable opinions compared with in-person assessments.

Because most evidence on telepsychiatric assessment comes from clinical settings, the introduction of remote assessments in Chile’s pension system created a natural setting for a before-and-after comparison involving the same assessor; the study examined whether remote care changed expert assessment criteria and how it affected coverage. Using March of each year as the index month, 568 assessments by a single assessor were analyzed: 112 conducted in person between 2019 and 2021 and 456 conducted remotely between 2022 and 2025. Remote assessments followed a supervised model: applicants attended a regional Medical Commission office, presented identification, and had their connection managed by institutional staff; the country has seven psychiatrists per 100,000 people, concentrated in the capital (OECD, 2022). With remote care, the number of regions served increased eightfold (from 1 to 8), the volume per index month tripled, and 400 assessments were conducted in seven cities outside the Metropolitan Region. The criteria remained unchanged: in the capital, the only location where both modalities were used, favorable opinions accounted for 50.0% of in-person assessments and 53.6% of remote assessments (p=0.74); the rate in the regions was similar to the metropolitan rate (47.8% versus 53.6%), and no difference remained after adjustment for case mix; no temporal drift was detected during the remote assessment period (p=0.60). The authors state that remote care did not dilute the expert assessment standard but extended its reach, and that the reproducible component, regardless of the assessor, is the standardized institutional connection point. The data support the pension system’s decision: access multiplied while the standard was maintained.

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