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Jiang J, Zheng Z. Medical Information Protection in Internet Hospital Apps in China: Scale Development and Content Analysis. JMIR Mhealth Uhealth 2024; 12:e55061. [PMID: 38904994 PMCID: PMC11226934 DOI: 10.2196/55061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/23/2024] [Accepted: 05/22/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Hospital apps are increasingly being adopted in many countries, especially since the start of the COVID-19 pandemic. Web-based hospitals can provide valuable medical services and enhanced accessibility. However, increasing concerns about personal information (PI) and strict legal compliance requirements necessitate privacy assessments for these platforms. Guided by the theory of contextual integrity, this study investigates the regulatory compliance of privacy policies for internet hospital apps in the mainland of China. OBJECTIVE In this paper, we aim to evaluate the regulatory compliance of privacy policies of internet hospital apps in the mainland of China and offer recommendations for improvement. METHODS We obtained 59 internet hospital apps on November 7, 2023, and reviewed 52 privacy policies available between November 8 and 23, 2023. We developed a 3-level indicator scale based on the information processing activities, as stipulated in relevant regulations. The scale comprised 7 level-1 indicators, 26 level-2 indicators, and 70 level-3 indicators. RESULTS The mean compliance score of the 52 assessed apps was 73/100 (SD 22.4%), revealing a varied spectrum of compliance. Sensitive PI protection compliance (mean 73.9%, SD 24.2%) lagged behind general PI protection (mean 90.4%, SD 14.7%), with only 12 apps requiring separate consent for processing sensitive PI (mean 73.9%, SD 24.2%). Although most apps (n=41, 79%) committed to supervising subcontractors, only a quarter (n=13, 25%) required users' explicit consent for subcontracting activities. Concerning PI storage security (mean 71.2%, SD 29.3%) and incident management (mean 71.8%, SD 36.6%), half of the assessed apps (n=27, 52%) committed to bear corresponding legal responsibility, whereas fewer than half (n=24, 46%) specified the security level obtained. Most privacy policies stated the PI retention period (n=40, 77%) and instances of PI deletion or anonymization (n=41, 79%), but fewer (n=20, 38.5%) committed to prompt third-party PI deletion. Most apps delineated various individual rights, but only a fraction addressed the rights to obtain copies (n=22, 42%) or to refuse advertisement based on automated decision-making (n=13, 25%). Significant deficiencies remained in regular compliance audits (mean 11.5%, SD 37.8%), impact assessments (mean 13.5%, SD 15.2%), and PI officer disclosure (mean 48.1%, SD 49.3%). CONCLUSIONS Our analysis revealed both strengths and significant shortcomings in the compliance of internet hospital apps' privacy policies with relevant regulations. As China continues to implement internet hospital apps, it should ensure the informed consent of users for PI processing activities, enhance compliance levels of relevant privacy policies, and fortify PI protection enforcement across the information processing stages.
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Affiliation(s)
- Jiayi Jiang
- Law School, Central South University, Changsha, China
| | - Zexing Zheng
- Law School, Central South University, Changsha, China
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Yang H, Hu Z, Jiang J, Li D. Telehealth Use Across Time and Regional Medical Resources During the COVID-19 Pandemic: Evidence from China. Telemed J E Health 2023; 29:1769-1780. [PMID: 37093158 DOI: 10.1089/tmj.2022.0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic has created lots of difficulties for individuals to seek medical help offline. Telehealth is considered as a potential approach to solve this issue. During the COVID-19 pandemic, although the use of telehealth has increased in the short term, it still remains unknown whether the use of telehealth can maintain a high level of development in the long term. The purpose of this article is to investigate the impact of COVID-19 pandemic on telehealth use across time and regional medical resources. Materials and Methods: Our research used the Internet search index from Baidu Index Platform in 31 provinces of China as the proxy of telehealth use. A total of 2,119,486 times of searching behaviors from January 2018 to December 2021 are included in our dataset. Changing plots, the method of analysis of variance and empirical models are applied to reveal the relationship between COVID-19 pandemic and telehealth use. Results: Baidu Index counts increased (p < 0.01) at the beginning of COVID-19 pandemic (2020) but started to decline (p < 0.01) during the period of regular epidemic prevention and control (2021). Moreover, the counts of Baidu Index in regions with rich medical resources are higher than those in other regions in 2020. Comparing Baidu Index counts in 2020, the COVID-19 pandemic has higher positive effects on telehealth use during the period of 2021 in regions with average and poor medical resources. Conclusions: COVID-19 pandemic has a positive effect on telehealth use in 2020 but has a negative effect in 2021. During the epidemic, telehealth use differs in regions with rich, average, and poor medical resources. Our findings indicate that the use of telehealth should be promoted with different measures in regions with different medical resources, thereby contributing its healthy development in the long term.
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Affiliation(s)
- Hualong Yang
- Department of e-Commerce, School of Management, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Zhibin Hu
- Department of Management Science and Engineering, School of Management, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Jin Jiang
- Department of Public Affairs Administration, School of Health Management, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Dan Li
- Department of Business Administration, School of Business Administration, Guangdong University of Finance, Guangzhou, China
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Lee J. Effects of private health insurance on healthcare services during the MERS Pandemic: Evidence from Korea. Heliyon 2023; 9:e22241. [PMID: 38046131 PMCID: PMC10686881 DOI: 10.1016/j.heliyon.2023.e22241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
This study investigates how private health insurance impacted healthcare services during the MERS pandemic in Korea. Using the Korea Health Panel Study (KHPS), this study examines the difference in healthcare utilization between insured and uninsured individuals during the pandemic. If insured individuals use fewer healthcare services than the uninsured during the MERS pandemic, it could be evidence of moral hazard. During the MERS outbreak, the probability of outpatient medical services utilization was lower by 19 % than during non-pandemic periods. All individuals decreased the number of outpatient visits by 7 %. Insured individuals reduced outpatient visits more than the uninsured in response to the MERS pandemic. The increased outpatient utilization by private health insurance could be attributed to both moral hazard and adverse selection. However, given that people with poor health cannot enroll in private health insurance due to the insurance company's screening process, moral hazard leads to increase healthcare utilization rather than adverse selection.
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Affiliation(s)
- Jugntaek Lee
- Department of Economics, Dongguk University, Seoul, Republic of Korea
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Gong W, Liu J. Investigating the Predictors of Telemedicine Service Usage Intention in China During the COVID-19 Pandemic: An Extended Technology Acceptance Perspective. Telemed J E Health 2023; 29:1390-1398. [PMID: 37010406 DOI: 10.1089/tmj.2022.0352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Introduction: In China, digital health and telemedicine services grew particularly rapidly during the COVID-19 pandemic. The goal of this study was to examine the effects of technology acceptance model (TAM) predictors, previous social media health service exposure, and telemedicine experience on individual telemedicine service usage intention within the extended theoretical framework of TAM and TAM2. Methods: The study adopted a cross-sectional survey to collect data (N = 1,088) through a Chinese online panel provider (wenjuan.com). Structural equation modeling was performed to examine relationships between the variables in the proposed model. Results: Our results indicated that technology anxiety (TA) was negatively related to perceived ease of use (PEOU) and usage intention. PEOU mediated the relationship between TA and usage intention. Social media health information consumption was positively associated with perceived usefulness (PU). Previous telemedicine satisfaction was positively related to PEOU and PU, but the direct relationship between satisfaction with telemedicine and usage intention was not found to be significant. Besides, PEOU and PU mediated the relationship between previous telemedicine satisfaction and usage intention. Conclusions: Findings of the study not only contribute to literature pertaining to telemedicine promotion by identifying important mediation relationships but also help identify potential users and provide a convenient internet-based promotion channel since they reveal that social media health information consumption is positively related to PU of telemedicine services.
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Affiliation(s)
- Wanqi Gong
- Department of Network and New Media, School of Journalism and Communication, Guangdong University of Foreign Studies, Guangzhou, China
| | - Jiawei Liu
- Department of Journalism, School of Journalism and Communication, Jinan University, Guangzhou, China
- China's National Cohesion Research Center, Jinan University, Guangzhou, China
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Deng W, Yang T, Deng J, Liu R, Sun X, Li G, Wen X. Investigating Factors Influencing Medical Practitioners' Resistance to and Adoption of Internet Hospitals in China: Mixed Methods Study. J Med Internet Res 2023; 25:e46621. [PMID: 37523226 PMCID: PMC10425818 DOI: 10.2196/46621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND The swift shift toward internet hospitals has relied on the willingness of medical practitioners to embrace new systems and workflows. Low engagement or acceptance by medical practitioners leads to difficulties in patient access. However, few investigations have focused on barriers and facilitators of adoption of internet hospitals from the perspective of medical practitioners. OBJECTIVE This study aims to identify both enabling and inhibiting predictors associated with resistance and behavioral intentions of medical practitioners to use internet hospitals by combining the conservation of resources theory with the Unified Theory of Acceptance and Use of Technology and technostress framework. METHODS A mixed methods research design was conducted to qualitatively identify the factors that enable and inhibit resistance and behavioral intention to use internet hospitals, followed by a quantitative survey-based study that empirically tested the effects of the identified factors. The qualitative phase involved conducting in-depth interviews with 16 experts in China from June to August 2022. Thematic analysis was performed using the qualitative data analysis software NVivo version 10 (QSR International). On the basis of the findings and conceptual framework gained from the qualitative interviews, a cross-sectional, anonymous, web-based survey of 593 medical practitioners in 28 provincial administrative regions of China was conducted. The data collected were analyzed using the partial least squares method, with the assistance of SPSS 27.0 (IBM Corp) and Mplus 7.0 (Muthen and Muthen), to measure and validate the proposed model. RESULTS On the basis of qualitative results, this study identified 4 facilitators and inhibitors, namely performance expectancy, social influence, work overload, and role ambiguity. Of the 593 medical practitioners surveyed in the quantitative research, most were female (n=364, 61.4%), had a middle title (n=211, 35.6%) or primary title (n=212, 35.8%), and had an average use experience of 6 months every year. By conducting structural equation modeling, we found that performance expectancy (β=-.55; P<.001) and work overload (β=.16; P=.005) had the most significant impact on resistance to change. Resistance to change fully mediated the influence of performance expectancy and partially mediated the influences of social influence (variance accounted for [VAF]=43.3%; P=.002), work overload (VAF=37.2%; P=.03), and role ambiguity (VAF=12.2%; P<.001) on behavioral intentions to use internet hospitals. In addition, this study found that the sex, age, professional title, and use experience of medical practitioners significantly moderated the aforementioned influencing mechanisms. CONCLUSIONS This study investigated the factors that facilitate or hinder medical practitioners' resistance to change and their behavioral intentions to use internet hospitals. The findings suggest that policy makers avoid the resistance and further promote the adoption of internet hospitals by ensuring performance expectancy and social influence and eliminating work overload and role ambiguity.
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Affiliation(s)
- Wenhao Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Tianan Yang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Jianwei Deng
- School of Management and Economics, Beijing Institute of Technology, Beijing, China
- Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China
| | - Ran Liu
- School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Xueqin Sun
- Department of Medical Insurance Management, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Gang Li
- TongJi Hospital, TongJi Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinmei Wen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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Wei Q, Wang X, Zhang G, Li X, Yang X, Gu D. Internet Healthcare Policy Analysis, Evaluation, and Improvement Path: Multidimensional Perspectives. Healthcare (Basel) 2023; 11:1905. [PMID: 37444738 DOI: 10.3390/healthcare11131905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Internet healthcare is a crucial component of the healthcare industry's digital transformation and plays a vital role in achieving China's Healthy China strategy and promoting universal health. To ensure the development of internet healthcare is guided by scientifically sound policies, this study analyzes and assesses current policy texts, aiming to identify potential issues and inadequacies. By examining 134 national-level policy documents, utilizing multiple research methods, including policy bibliometrics, content analysis, and the PMC Index Model, the study investigates policy characteristics, distribution of policy instruments, and evaluation outcomes related to internet healthcare. The study findings reveal that internet healthcare policies place emphasis on enhancing service quality, driving technological innovation, and promoting management standardization. Although policy instruments align with the current stage of internet healthcare development in China, they are plagued by imbalances in implementation. While policies are generally well-formulated, there are discernible discrepancies among them, necessitating the reinforcement and refinement of certain provisions. Hence, it is imperative to strategically optimize the amalgamation and implementation of policy instruments while concurrently endeavoring to achieve a dynamic equilibrium in policy combinations. Furthermore, policymakers should diligently refine the policy content pertaining to its nature and effectiveness in order to fully maximize policy utility.
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Affiliation(s)
- Qi Wei
- School of Management, Hefei University of Technology, Hefei 230009, China
| | - Xiaoyu Wang
- The Department of Pharmacy, Anhui University of Traditional Chinese Medicine, Hefei 230009, China
| | - Gongrang Zhang
- School of Management, Hefei University of Technology, Hefei 230009, China
| | - Xingguo Li
- School of Management, Hefei University of Technology, Hefei 230009, China
| | - Xuejie Yang
- School of Management, Hefei University of Technology, Hefei 230009, China
| | - Dongxiao Gu
- School of Management, Hefei University of Technology, Hefei 230009, China
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Chen X, Wu X, Zhang Q, Jing R, Cheng W, Tian J, Jin C. The construction and operational models of internet hospitals in China: a hospital-based survey study. BMC Health Serv Res 2023; 23:669. [PMID: 37344831 DOI: 10.1186/s12913-023-09675-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 06/08/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND China has empowered and continues to empower internet hospitals, which saw an increase in their development due to the pandemic, to fight against COVID-19. The construction and operational models of internet hospitals can be categorized as self-constructed and self-managed models, self-constructed and enterprise-run models, hospital and enterprise joint-owned models, and hosted by a third-party platform. Despite the growing importance of internet hospitals, there have been few systematic summaries of their construction and operational models. The primary purpose of the study was to understand the construction and operational models of internet hospitals in China. METHODS Data was collected from 39 internet hospitals and 356 medical staff between September 2020 and April 2021, via internet hospital and hospital staff surveys. T-tests were used to compare the continuous variables, while Chi-square tests were employed to compare the proportions of categorical variables. The self-perception of the internet hospitals' services was assessed using a 5-point Likert scale on 16 aspects and a root cause analysis was conducted to identify the root causes and influencing factors of current deficiencies experienced by internet hospitals. RESULTS Among the 39 internet hospitals, 22 (56.4%) were self-constructed and self-managed. Compared to other models of Internet hospitals, self-constructed and self-managed hospitals had lower percentages of professionals providing online services (P = 0.006), numbers of doctors outside of the entity (P = 0.006), numbers of online nurses (P = 0.004), and the ratio of online nurses to offline doctors (P < 0.001). Of the 16 aspects evaluated with regards to the medical staff's self-perception of the internet hospital services, the highest scores were given for fee transparency, fee rationality, travel cost capital, patience and responsibility, and consultation behaviors. The root causes included five aspects: human, channels, prices, services, and time. CONCLUSIONS While the self-constructed and self-managed model was found to be the most prevalent form of internet hospital in China, the different models of internet hospitals can have an impact on both the quantity and quality of online healthcare services. This study contributes to the existing literature on internet hospitals' construction and operational models, offering additional policy implications for telemedicine management.
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Affiliation(s)
- Xuejiao Chen
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
| | - Xinxia Wu
- Peking University Third Hospital, Beijing, China
| | - Qihang Zhang
- London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Ran Jing
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
| | - Weibin Cheng
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China.
- School of Data Science, City University of Hong Kong, Hong Kong S.A.R, China.
| | - Junzhang Tian
- Institute for Healthcare Artificial Intelligence Application, Guangdong Second Provincial General Hospital, Haizhu District, No.466 Xingangzhong Road, Guangzhou, Guangdong, 510317, China
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Pan X, Zhou X, Yu L, Hou L. Switching from offline to online health consultation in the post-pandemic era: the role of perceived pandemic risk. Front Public Health 2023; 11:1121290. [PMID: 37261233 PMCID: PMC10227577 DOI: 10.3389/fpubh.2023.1121290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 04/28/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Due to its effectiveness and various benefits, the use of online health consultation (OHC) has dramatically increased in recent years, especially since the outbreak of the COVID-19 pandemic. However, underlying mechanism whereby the pandemic impacted OHC usage is still unclear. Methods Via an online survey (N=318), the present paper measures the users' perceptions towards both offline and online services, their intention to switch to OHC, and the perceived pandemic risks. The relationships among these factors are conceptualized by the push-pull-mooring framework, and tested via structural equation modelling. Results Dissatisfaction with offline service (process inefficiency and consultation anxiety), the attractiveness of OHC (perceived benefits and perceived ease of use), and users' behavioral inertia (switching cost and habit) jointly influence the intention to switching to OHC. The significant role of the perceived pandemic risk of going to medical facilities is particularly addressed. On the one hand, the perceived pandemic risk is found with an indirect impact on the switching intention by enlarging the dissatisfaction with offline service and the attractiveness of OHC. On the other hand, a high perceived pandemic risk induces more actual switching behavior and also amplifies the transition from switching intention to behavior. Discussion The study provides novel insights into the understanding of OHC usage in the post-pandemic era, and also informs medical facilities, OHC platforms, and policymakers on managing and balancing the online and offline healthcare provision.
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Affiliation(s)
| | | | | | - Lei Hou
- School of Management Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China
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Li D, Hu Y, Liu S, Li G, Lu C, Yuan S, Zhang Z. The effect of using internet hospitals on the physician-patient relationship: Patient perspective. Int J Med Inform 2023; 174:105058. [PMID: 37002986 DOI: 10.1016/j.ijmedinf.2023.105058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Internet hospitals are rapidly developing in China. Despite many studies regarding internet hospitals, there has been little further research that evaluates the impact of using internet hospitals on the physician-patient relationship during outpatient visits. METHODS We developed a questionnaire based on the patient-doctor relationship questionnaire (PDRQ-9) to survey the physician-patient relationship. A sample of 505 patients who sought medical services from offline physical or internet hospitals was selected by convenience sampling. Multiple linear regression analysis was performed to determine whether the use of internet hospitals during outpatient visits was associated with the physician-patient relationship. RESULTS Internet hospital users gave significantly lower scores than nonusers in total physician-patient relationship scores (P =.01) and in the 5 items of "My physician helps me" (P <.001), "I trust my physician" (P =.001), "My physician understands me" (P =.002), "My physician and I agree on the nature of my medical symptoms" (P =.01), and "I can talk to (communicate with) my physician freely" (P =.005). Multiple linear regression results showed that the use of internet hospitals during outpatient visits influenced the physician-patient relationship. And after controlling for other patient characteristics, the use of internet hospitals decreased the physician-patient relationship scores by 11.9%. CONCLUSIONS Our findings suggest that the current use of internet hospitals could not significantly enhance the physician-patient relationship during outpatient visits. Therefore, we should work on improving physicians' online communication skills and strengthening the level of trust between physicians and their patients. Policymakers should also pay close attention to the gap of the physician-patient relationship between internet hospitals and offline physical hospitals.
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Affiliation(s)
- Dehe Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Yinhuan Hu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Sha Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Gang Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Chuntao Lu
- Jingmen No. 2 People's Hospital, Jingmen, Hubei, China.
| | - Shaochun Yuan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Zemiao Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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10
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Bian D, Xiao Y, Song K, Dong M, Li L, Millar R, Shi C, Li G. Determinants Influencing the Adoption of Internet Health Care Technology Among Chinese Health Care Professionals: Extension of the Value-Based Adoption Model With Burnout Theory. J Med Internet Res 2023; 25:e37671. [PMID: 36897630 PMCID: PMC10039406 DOI: 10.2196/37671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/15/2022] [Accepted: 01/15/2023] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The global COVID-19 pandemic has been widely regarded as a catalyst for adopting internet health care technology (IHT) in China. IHT consists of new health care technologies that are shaping health services and medical consultations. Health care professionals play a substantial role in the adoption of any IHT, but the consequences of doing so can often be challenging, particularly when employee burnout is prevalent. Few studies have explored whether employee burnout influences the adoption intention of IHT in health care professionals. OBJECTIVE This study aims to explain the determinants influencing the adoption of IHT from the perspective of health care professionals. To do so, the study extends the value-based adoption model (VAM) with consideration for employee burnout as a determining factor. METHODS A cross-sectional web-based survey using a sample of 12,031 health care professionals selected through multistage cluster sampling from 3 provinces in mainland China was conducted. The hypotheses of our research model were developed based on the VAM and employee burnout theory. Structural equation modeling was then used to test the research hypotheses. RESULTS The results indicate that perceived usefulness, perceived enjoyment, and perceived complexity positively correlate with perceived value (β=.131, P=.01; β=.638, P<.001; β=.198, P<.001, respectively). Perceived value had a positive direct effect on adoption intention (β=.725, P<.001), perceived risk negatively correlated with perceived value (β=-.083, P<.001), and perceived value negatively correlated with employee burnout (β=-.308, P<.001). In addition, employee burnout was negatively related to adoption intention (β=-.170, P<.001) and mediated the relationship between perceived value and adoption intention (β=.052, P<.001). CONCLUSIONS Perceived value, perceived enjoyment, and employee burnout were the most important determinants of IHT adoption intention by health care professionals. In addition, while employee burnout was negatively related to adoption intention, perceived value inhibited employee burnout. Therefore, this study finds that it is necessary to develop strategies to improve the perceived value and reduce employee burnout, which will benefit the promotion of the adoption intention of IHT in health care professionals. This study supports the use of the VAM and employee burnout in explaining health care professionals' adoption intention regarding IHT.
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Affiliation(s)
- Dongsheng Bian
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Clinical Nutrition, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyin Xiao
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Keyu Song
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minye Dong
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Li
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Ross Millar
- Health Services Management Centre, University of Birmingham, Birmingham, United Kingdom
| | - Chenshu Shi
- Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Guohong Li
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
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Huang F, Liu H. The impact of the COVID-19 pandemic and related policy responses on non-COVID-19 healthcare utilization in China. HEALTH ECONOMICS 2023; 32:620-638. [PMID: 36397307 DOI: 10.1002/hec.4636] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/20/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
We investigate the impact of the COVID-19 pandemic and related policy responses on non-COVID-19 healthcare utilization (i.e., different types of outpatient care) up to October 2020 in China. Using an administrative database from a large prefecture-level city, we find that both direct exposure to the COVID-19 pandemic and the strict containment policy responses led to reductions in outpatient care utilization. The largest decline during the lockdown was observed in preventive care visits, which nevertheless recovered to pre-pandemic levels 2 months after the lockdown. The disruptions in prenatal care visits could not be offset by the recovery later on. Chronic care and emergency department visits had not returned to pre-pandemic levels as of October 2020, which may be driven by extended days' supply of prescription medication, increased use of telemedicine, and improved health-protective behaviors. In the reopening period, there were increases in visits for mental and sleep disorders, especially among children, and for medical abortion. Among health facilities at all levels, primary care facilities saw the least reductions in total outpatient visits. Our results emphasize the need for strategies to ensure access to urgent or essential care services when managing the current epidemiologic transition and future crises.
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Affiliation(s)
- Feng Huang
- School of Economics, Shanghai University of Finance and Economics, Shanghai, China
| | - Hong Liu
- School of Labor and Human Resources, Renmin University of China, Beijing, China
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12
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Jiang Y, Lau AKW. Understanding Post-Adoption Behavioral Intentions of Mobile Health Service Users: An Empirical Study during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3907. [PMID: 36900918 PMCID: PMC10001414 DOI: 10.3390/ijerph20053907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
This study aims to understand the post-adoption behaviors of mobile health (m-Health) service users during the COVID-19 pandemic. Drawing on the stimulus-organism-response framework, we examined the effects of user personality traits, doctor characteristics, and perceived risks on user continuance intentions and positive word of mouth (WOM) when using m-Health, as mediated by cognitive and emotional trust. The empirical data were collected via an online survey questionnaire from 621 m-Health service users in China and were verified with partial least squares structural equation modeling. The results showed that personal traits and doctor characteristics were positively associated and the perceived risks were negatively associated with both cognitive and emotional trust. Both cognitive and emotional trust significantly influenced users' post-adoption behavioral intentions in terms of continuance intentions and positive WOM, with different magnitudes. This study provides new insights for the promotion of the sustainable development of m-Health businesses after or during the pandemic.
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Affiliation(s)
- Yanmei Jiang
- The School of Business, Anhui University of Technology, Ma’anshan 243032, China
- Key Laboratory of Multidisciplinary Management and Control of Complex Systems of Anhui Higher Education Institutes, Anhui University of Technology, Ma’anshan 243032, China
| | - Antonio K. W. Lau
- The School of Management, Kyung Hee University, Seoul 02447, Republic of Korea
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Wang S, Wang X, Zhou Y, Xu J. Utilization of, satisfaction toward, and challenges for Internet-based healthcare services provided by primary health institutions: Evidence from China. Front Public Health 2023; 10:1100634. [PMID: 36743153 PMCID: PMC9892623 DOI: 10.3389/fpubh.2022.1100634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/27/2022] [Indexed: 01/20/2023] Open
Abstract
Background The rapid development of "Internet plus healthcare" in China has provided new ways for the innovative development of primary healthcare. In addition, a series of favorable policies have been issued to promote Internet-based healthcare services in primary health institutions. Objective The aim of this study was to describe the utilization of, satisfaction toward, and challenges faced by Internet-based healthcare services provided by primary health institutions in China. Methods A self-designed structured questionnaire was employed to collect related data in January 2022 through Credamo. The questionnaire mainly included sociodemographic characteristics, health-related information, utilization of, satisfaction toward, and challenges faced by Internet-based healthcare services provided by primary health institutions. Descriptive analysis was used to describe the sociodemographic characteristics, utilization, satisfaction, and challenges by subgroups. The Wilcoxon rank-sum test was carried out to examine the differences in satisfaction with Internet-based healthcare services between participants who ever received these services and those who did not. A multiple logistic regression model was also used to examine the factors influencing the utilization of Internet-based healthcare services provided by primary health institutions. Results A total of 10,600 residents were included in the final analysis, of whom 5,754 (54.3%) were women. Overall, 51.3% (5,434) of the total participants ever used Internet-based healthcare services provided by primary health institutions. Among those who used Internet-based healthcare services, the most widely used services were procedure-related consultation services (63.7%). The satisfaction among those who ever used it was significantly higher than that among those who did not (84.7 vs. 45.4%; p-value < 0.001). One of the biggest challenges (69.3%) expressed by the residents was that it was difficult for the elderly to use Internet-based services, followed by community doctors with low capacity of providing primary care online (49.0%) and residents were worried about the information security and privacy protection (48.5%). Younger people, people with lower education levels, and people with chronic diseases were significantly more likely to use Internet-based healthcare services provided by primary health institutions (P < 0.05). Conclusion Among 10,600 residents surveyed in China in 2022, more than half of the people used Internet-based healthcare services provided by primary health institutions, and most of them were satisfied, although subgroups significant differences existed. The most common use was procedure-related (e.g., online registration and result query), and several challenges of using Internet-based healthcare services exist (e.g., information safety and usage among elderly people). Therefore, it is important to further improve Internet-based primary healthcare services based on the population perception of achieving healthy China in 2030.
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Affiliation(s)
- Shuo Wang
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xin Wang
- School of Public Health, Health Development Research Center, Sun Yat-sen University, Guangzhou, China
| | - Yuyin Zhou
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Junfang Xu
- Center for Health Policy Studies, School of Public Health, Zhejiang University School of Medicine, Hangzhou, China,Department of Pharmacy, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Junfang Xu ✉
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Liu X, Jia C, Cheng J, Wang X, Wang Q, Li H. Measuring Productivity and Relative Efficiency of Public Tertiary Traditional Chinese Medicine Hospitals in Hubei, China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231190576. [PMID: 37621138 PMCID: PMC10467214 DOI: 10.1177/00469580231190576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 08/26/2023]
Abstract
Improving the productivity and relative efficiency of traditional Chinese medicine (TCM) hospitals is pivotal for hospital managers and policymakers to optimize the utilization of TCM resources in China. This study aimed to measure the productivity and relative efficiency of public tertiary TCM hospitals in Hubei Province. The input and output indicators data were extracted from the Health Commission of Hubei Province (HCHP) from 2019 to 2021. The Bootstrap-Malmquist-DEA model was employed to measure the productivity and relative efficiency of the hospitals. The statistical significance was set at P < .05. The numbers of total diagnostic patients and discharged patients declined by 23.44% and 28.34% from 2019 to 2020, and then increased by 25.76% and 20.44% respectively from 2020 to 2021. The average bias-corrected technical efficiency (TE) scores of the TCM hospitals from 2019 to 2021 were 0.8391, 0.8048, and 0.8559, indicating good efficiency. The average total factor productivity (TFP) in 2020 and 2021 decreased compared to that in 2019, with scores of 0.7479 and 0.8996, respectively. Between 2019 and 2020, the TFP changes among 19 out of 21 (90.48%) TCM hospitals and the technological changes (TC) among 20 out of 21 (95.24%) were less than 1.0000 (P < .05). The TFP changes of 17 out of 21 (80.95%) TCM hospitals and the TC of 20 out of 21 (95.24%) were less than 1.0000 (P < .05) between 2019 and 2021. COVID-19 might have constrained the provision of healthcare services by the public tertiary TCM hospitals in Hubei Province. Priority should be given to the utilization of healthcare resources, performance evaluation, information system strengthening, and internal hospital management to boost technical efficiency. TCM hospitals need to focus further on technology innovation to improve their technological progress.
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Affiliation(s)
- Xinliang Liu
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
- School of Health Sciences, The University of Manchester, Manchester, UK
| | - Changli Jia
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Jiahui Cheng
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Xin Wang
- Department of Orthopaedics Trauma and Microsurgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Quan Wang
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
| | - Hao Li
- School of Public Health/Global Health Institute, Wuhan University, Wuhan, China
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Bu F, Sun H, Li L, Tang F, Zhang X, Yan J, Ye Z, Huang T. Artificial intelligence-based internet hospital pharmacy services in China: Perspective based on a case study. Front Pharmacol 2022; 13:1027808. [PMID: 36438784 PMCID: PMC9682042 DOI: 10.3389/fphar.2022.1027808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Background: Recently, internet hospitals have been emerging in China, saving patients time and money during the COVID-19 pandemic. In addition, pharmacy services that link doctors and patients are becoming essential in improving patient satisfaction. However, the existing internet hospital pharmacy service mode relies primarily on manual operations, making it cumbersome, inefficient, and high-risk. Objective: To establish an internet hospital pharmacy service mode based on artificial intelligence (AI) and provide new insights into pharmacy services in internet hospitals during the COVID-19 pandemic. Methods: An AI-based internet hospital pharmacy service mode was established. Initially, prescription rules were formulated and embedded into the internet hospital system to review the prescriptions using AI. Then, the “medicine pick-up code,” which is a Quick Response (QR) code that represents a specific offline self-pick-up order, was created. Patients or volunteers could pick up medications at an offline hospital or drugstore by scanning the QR code through the window and wait for the dispensing machine or pharmacist to dispense the drugs. Moreover, the medication consultation function was also operational. Results: The established internet pharmacy service mode had four major functional segments: online drug catalog search, prescription preview by AI, drug dispensing and distribution, and AI-based medication consultation response. The qualified rate of AI preview was 83.65%. Among the 16.35% inappropriate prescriptions, 49% were accepted and modified by physicians proactively and 51.00% were passed after pharmacists intervened. The “offline self-pick-up” mode was preferred by 86% of the patients for collecting their medication in the internet hospital, which made the QR code to be fully applied. A total of 426 medication consultants were served, and 48.83% of them consulted outside working hours. The most frequently asked questions during consultations were about the internet hospital dispensing process, followed by disease diagnosis, and patient education. Therefore, an AI-based medication consultation was proposed to respond immediately when pharmacists were unavailable. Conclusion: The established AI-based internet hospital pharmacy service mode could provide references for pharmacy departments during the COVID-19 pandemic. The significance of this study lies in ensuring safe/rational use of medicines and raising pharmacists’ working efficiency.
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Affiliation(s)
- Fengjiao Bu
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Hong Sun
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Ling Li
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Fengmin Tang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xiuwen Zhang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Jingchao Yan
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Zhengqiang Ye
- Information Center, Eye & ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Taomin Huang, ; Zhengqiang Ye,
| | - Taomin Huang
- Department of Pharmacy, Eye & ENT Hospital, Fudan University, Shanghai, China
- *Correspondence: Taomin Huang, ; Zhengqiang Ye,
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Yang B, Wen Q, Zhang Y, Wang X, Yin X, Li Q, Li Q, Song L. Economic value and characteristics of cloud pharmacy for children based on internet hospital in western China during the COVID-19 pandemic: Cross-sectional survey study. Front Public Health 2022; 10:1034450. [PMID: 36408041 PMCID: PMC9669979 DOI: 10.3389/fpubh.2022.1034450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
Background Online health care services have been encouraged by the Chinese government in recent years, and the COVID-19 pandemic catalyzed the rapid growing of internet hospitals. As an integral part of online health care services, little is known about the economic value and characteristics of cloud pharmacy especially for children. This study aimed to reveal the economic value and comprehensive characteristics of pediatric cloud pharmacy during the COVID-19 pandemic in a tertiary children's hospital in western China. Methods A total of 33,254 online prescriptions over the course of February 2020 through December 2021 were analyzed with respect to the user profiles, diseases, consulting behaviors, distribution of departments, delivery region and distance, drug information and degree of satisfaction. The cost savings for patients calculated lost wages and the high-speed railway fees for transport to and from hospital. Results A total of 33,254 prescriptions, including 56,216 drugs were delivered to 27 provinces and municipalities of China. The internet cloud pharmacy saved a total of more than RMB 11.17 million in financial costs for patients. Of the 33,254 delivered prescriptions, 50.40% were sent to Chongqing Province, the top 5 provinces for out-of-province prescription deliveries were Sichuan (37.77%), Guizhou (8.00%), Yunnan (1.18%), Hubei (0.66%) and Guangdong (0.42%). In terms of department distribution, neurology (31.7%), respiratory (15.0%) and endocrinology (14.6%) were the top three departments. Epilepsy (16.2%), precocious puberty (10.3%) and asthma (8.7%) were the top three frequently consulted diseases. The peak times of day for online prescriptions occurred at 9 AM and 8 PM. 99.67% of users gave full marks for their internet counseling. Conclusion The pediatric cloud pharmacy is efficient, cost-saving and convenient for children with chronic disease or mild symptoms during the COVID-19 pandemic. The widespread use of this pediatric cloud pharmacy can help alleviating pressure on offline hospitals and facilitated people's lives beyond geographical and time-related limitations. Further efforts are needed to be made to improve the quality and acceptance of pediatric cloud pharmacy, as well as to regulate and standardize the management of this novel online health care service.
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Affiliation(s)
- Bin Yang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Qiang Wen
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Yi Zhang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiuling Wang
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - Xiangdong Yin
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China,Department of Information, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qianbo Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China,Department of Information, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qinling Li
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China,Department of Internet Hospital Office, Children's Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Qinling Li
| | - Lin Song
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Chongqing, China,Chongqing Key Laboratory of Pediatrics, Chongqing, China,Lin Song
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Xiong HY, Zhang G, Wang L, Li Z, Shen Q, Li Y, Zhu H, Du Y, Sun L, Zhao B, Zhao L, Fu H, Li X, Gao X, Hao S, Ding J, Chen Z, Xu Z, Liu X, Tao Y, Zhang A, Li Q, Wang M. Psychological research of the children with chronic kidney disease and their guardians during the COVID-19 pandemic. Front Public Health 2022; 10:922678. [PMID: 36324445 PMCID: PMC9621117 DOI: 10.3389/fpubh.2022.922678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/27/2022] [Indexed: 01/22/2023] Open
Abstract
Background There is great mental stress due to the coronavirus disease 2019 (COVID-19) pandemic. However, there are no detailed psychological studies of the children with chronic kidney disease (CKD) and their guardians during the COVID-19 pandemic. Objective This study explores the psychological pressure on children with CKD and their guardians. Methods An online survey was conducted at 20 of the largest pediatric nephropathy departments in China, including the Rutter Parent Questionnaire, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Overall, 885 children (589 children with CKD associated with 296 children of the control group) completed the survey together with their guardians. Results There was no statistical difference between CKD children and control children regarding their Rutter behavior scores and abnormal behaviors. Nevertheless, the abnormal behavior of children might aggravate the anxiety and depression of guardians in both CKD and control groups (p < 0.05). We confirmed that the anxiety and depression of guardians in the CKD group were both significantly higher than those in the control group (p < 0.05). The guardians in the CKD group with lower annual income were more likely to experience anxiety (p < 0.05). Furthermore, the guardians whose children were older than 11 years old might be more anxious than those who were 6-11 years old. Besides, the guardians in the CKD group who watched the news for 30-60 min daily were less likely to have depression than those who watched < 10 min (p < 0.05). The subgroup results showed that the gender, the time of watching the news, the annual income of guardians, and children's age might be the most critical factors influencing guardians' psychological burden. Conclusion The guardians in the CKD group have more severe anxiety and depression during the pandemic. The children's abnormal behavior, adolescents' pressure, low household income, and the panic about the pandemic may be the main reasons for the anxiety and depression of guardians.
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Affiliation(s)
- Hua-Ying Xiong
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Gaofu Zhang
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Wang
- Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhijuan Li
- Department of Nephrology, Xi'an Children's Hospital, Xi'an, China
| | - Qian Shen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Yuhong Li
- Department of Nephrology, Guiyang Children's Hospital, Guiyang, China
| | - Hongtao Zhu
- Department of Pediatrics, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, China
| | - Yue Du
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Liangzhong Sun
- Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Bo Zhao
- Department of Nephrology, Kunming Children's Hospital, Kunming, China
| | - Lijun Zhao
- Department of Nephrology, Shanxi Children's Hospital, Taiyuan, China
| | - Haidong Fu
- Department of Nephrology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Li
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaojie Gao
- Department of Nephrology, Shenzhen Children's Hospital, Shenzhen, China
| | - Sheng Hao
- Department of Nephrology and Rheumatology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Juanjuan Ding
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zongwen Chen
- Chongqing Three Gorges Central Hospital, Chongqing, China
| | - Zhiquan Xu
- Department of Nephrology, Rheumatology, and Immunology, Hainan Women and Children's Medical Center, Haikou, China
| | - Xiaorong Liu
- Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yuhong Tao
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Aihua Zhang
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiu Li
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Mo Wang
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,National Clinical Research Center for Child Health and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mo Wang
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Yu Y, Chen Z, Zhang J, Zhou P, Lu L, Lin B, Li Y. Factors Associated with Telemedicine Services Provision for Sexually Transmitted Disease Diagnosis and Treatment Among Dermatologists: Evidence from China. TELEMEDICINE REPORTS 2022; 3:166-173. [PMID: 36204703 PMCID: PMC9531886 DOI: 10.1089/tmr.2022.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Telemedicine has experienced rapid growth in China, with wide applications for chronic disease management. OBJECTIVE This study examined a unique survey dataset to identify the provision of telemedicine services by dermatologists, and to explore its association with physician characteristics, perception of diagnosis, and physicians' perceptions of the advantages and disadvantages of telemedicine. MATERIALS AND METHODS Responses to an anonymous voluntary questionnaire were collected from 238 dermatologists in Zhejiang Province, China, via a mixed mode of online and in-person data collection. Data were analyzed using Stata 16.0. Empirical analyses utilized descriptive statistics and multivariable logistical regression. RESULTS Among a total of 238 physicians, 34.9% provided telemedicine services. Results from the multivariable logistic regression indicated that, if physicians can use their spare time to help patients, seniority and their perception of the benefit of telemedicine are the two most important factors determining their likelihood of providing telemedicine services among the studied sample. CONCLUSION Telemedicine holds great promise, but its practices need to be more efficient to save time and reduce the risk of misdiagnosis so that more physicians may participate.
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Affiliation(s)
- Yingzhe Yu
- Department of Dermatology, Ningbo First Hospital, Ningbo, China
| | - Zhuo Chen
- School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham Ningbo China, Ningbo, China
- Department of Health Policy and Management, University of Georgia, Athens, Georgia, USA
| | - Jing Zhang
- Department of Dermatology, Ningbo First Hospital, Ningbo, China
| | - Ping Zhou
- Department of Dermatology, Ningbo First Hospital, Ningbo, China
| | - Lingyi Lu
- Department of Dermatology, Ningbo First Hospital, Ningbo, China
| | - Bingjiang Lin
- Department of Dermatology, Ningbo First Hospital, Ningbo, China
| | - Yang Li
- School of Economics, Faculty of Humanities and Social Sciences, University of Nottingham Ningbo China, Ningbo, China
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Liu S, Zhao H, Fu J, Kong D, Zhong Z, Hong Y, Tan J, Luo Y. Current status and influencing factors of digital health literacy among community-dwelling older adults in Southwest China: a cross-sectional study. BMC Public Health 2022; 22:996. [PMID: 35581565 PMCID: PMC9112275 DOI: 10.1186/s12889-022-13378-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The rapid development of digital health has reduced the time and cost of medical treatment, bringing efficient and economical benefits. However, older adults all over the world are deficient in digital health knowledge and skills to varying degrees. This study intends to investigate the current status and influencing factors of digital health literacy among community-dwelling older adults in Southwest China, so as to provide theoretical reference for global digital health researches and the construction of gerontological digital health service models. METHODS A cross-sectional survey was conducted from September 2020 to April 2021 in Chongqing, China. 572 community-dwelling older adults (≥ 65 years) were surveyed by stratified sampling. Data on sociodemographic characteristics, Internet usage, attitude towards Internet health information and digital health literacy were collected. Wherein, the digital health literacy assessment adopted the Digital Health Literacy Assessment Scale for community-dwelling older adults, which was developed by the research group, proven to be with good internal consistency (0.941), split-half reliability (0.889), test-retest reliability (0.941), content validity (0.967), criterion validity (0.938) and construct validity. The influencing factors were explored by univariate analysis and multiple linear regression analysis. RESULTS The average score of digital health literacy was 37.10 (SD 18.65). Univariate analysis showed that there were statistically significant differences in the comparison of digital health literacy according to 16 variables, such as different age and education levels. Multiple linear regression analysis showed that education level, marital status, self-rated health status, degree of health concerns, duration of Internet usage, time spent using the Internet per day, frequency of Internet usage, frequency of receiving guidance passively from family members, perceived usefulness, perceived ease of use and perceived reliability were positively correlated with digital health literacy, while age and perceived risk were negatively correlated with digital health literacy. CONCLUSION The overall digital health literacy of community-dwelling older adults in Southwest China is relatively low. In the future, health professionals should fully consider the diverse influencing factors of digital health literacy, assess individual differences and provide targeted intervention programs. Meanwhile, global public health authorities should integrate health resources effectively, and seek health service models for older adults in line with the development of the digital age to narrow the digital divide.
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Affiliation(s)
- Siqi Liu
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China
| | - Hongyan Zhao
- Xiaolongkan Community Health Care Service Centre, No. 4 Xiaolongkan Street, Shapingba District, Chongqing, 400030, P. R. China
| | - Jingjing Fu
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China
| | - Dehui Kong
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China
| | - Zhu Zhong
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China
| | - Yan Hong
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China
| | - Jing Tan
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China.
| | - Yu Luo
- School of Nursing, Army Medical University (Third Military Medical University), No. 30 Gaotanyan Street, Shapingba District, Chongqing, 400038, P. R. China.
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20
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Ge F, Qian H, Lei J, Ni Y, Li Q, Wang S, Ding K. Experiences and Challenges of Emerging Online Health Services Combating COVID-19 in China: A Retrospective, Cross-sectional Study of Internet Hospitals. JMIR Med Inform 2022; 10:e37042. [PMID: 35500013 PMCID: PMC9162135 DOI: 10.2196/37042] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 01/17/2023] Open
Abstract
Background Internet-based online virtual health services were originally an important way for the Chinese government to resolve unmet medical service needs due to inadequate medical institutions. Its initial development was not well received. Then, the unexpected COVID-19 pandemic produced a tremendous demand for telehealth in a short time, which stimulated the explosive development of internet hospitals. The Second Affiliated Hospital of Zhejiang University (SAHZU) has taken a leading role in the construction of internet hospitals in China. The pandemic triggered the hospital to develop unique research on health service capacity under strict quarantine policies and to predict long-term trends. Objective This study aims to provide policy enlightenment for the construction of internet-based health services to better fight against COVID-19 and to elucidate future directions through an in-depth analysis of 2 years of online health service data gleaned from SAHZU’s experiences and lessons learned. Methods We collected data from SAHZU Internet Hospital from November 1, 2019, to September 16, 2021. Data from over 900,000 users were analyzed with respect to demographic characteristics, demands placed on departments by user needs, new registrations, and consultation behaviors. Interrupted time series (ITS) analysis was adopted to evaluate the impact of this momentous emergency event and its long-term trends. With theme analysis and a defined 2D model, 3 investigations were conducted synchronously to determine users’ authentic demands on online hospitals. Results The general profile of internet hospital users is young or middle-aged women who live in Zhejiang and surrounding provinces. The ITS model indicated that, after the intervention (the strict quarantine policies) was implemented during the outbreak, the number of internet hospital users significantly increased (β_2=105.736, P<.001). Further, long-term waves of COVID-19 led to an increasing number of users following the outbreak (β_3=0.167, P<.001). In theme analysis, we summarized 8 major demands by users of the SAHZU internet hospital during the national shutdown period and afterwards. Online consultations and information services were persistent and universal demands, followed by concerns about medical safety and quality, time, and cost. Users’ medical behavior patterns changed from onsite to online as internet hospital demands increased. Conclusions The pandemic has spawned the explosive growth of telehealth; as a public tertiary internet hospital, the SAHZU internet hospital is partially and irreversibly integrated into the traditional medical system. As we shared the practical examples of 1 public internet hospital in China, we put forward suggestions about the future direction of telehealth. Vital experience in the construction of internet hospitals was provided in the normalization of COVID-19 prevention and control, which can be demonstrated as a model of internet hospital management practice for other medical institutions.
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Affiliation(s)
- Fangmin Ge
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Huan Qian
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Jianbo Lei
- Center for Medical Informatics, Health Science Center, Peking University, Beijing, CN
| | - Yiqi Ni
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Qian Li
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
| | - Song Wang
- School of Management, Zhejiang University, Hangzhou, CN
| | - Kefeng Ding
- The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, CN
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21
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Luo X, Xu W, Ming WK, Jiang X, Yuan Q, Lai H, Huang C, Zhong X. Cost-Effectiveness of Mobile Health-Based Integrated Care for Atrial Fibrillation: Model Development and Data Analysis. J Med Internet Res 2022; 24:e29408. [PMID: 35438646 PMCID: PMC9066334 DOI: 10.2196/29408] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 09/23/2021] [Accepted: 02/24/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Mobile health (mHealth) technology is increasingly used in disease management. Using mHealth tools to integrate and streamline care has improved clinical outcomes of patients with atrial fibrillation (AF). OBJECTIVE The aim of this study was to investigate the potential clinical and health economic outcomes of mHealth-based integrated care for AF from the perspective of a public health care provider in China. METHODS A Markov model was designed to compare outcomes of mHealth-based care and usual care in a hypothetical cohort of patients with AF in China. The time horizon was 30 years with monthly cycles. Model outcomes measured were direct medical cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses were performed to examine the robustness of the base-case results. RESULTS In the base-case analysis, mHealth-based care gained higher QALYs of 0.0730 with an incurred cost of US $1090. Using US $33,438 per QALY (three times the gross domestic product) as the willingness-to-pay threshold, mHealth-based care was cost-effective, with an ICER of US $14,936 per QALY. In one-way sensitivity analysis, no influential factor with a threshold value was identified. In probabilistic sensitivity analysis, mHealth-based care was accepted as cost-effective in 92.33% of 10,000 iterations. CONCLUSIONS This study assessed the expected cost-effectiveness of applying mHealth-based integrated care for AF according to a model-based health economic evaluation. The exploration suggested the potential cost-effective use of mHealth apps in streamlining and integrating care via the Atrial fibrillation Better Care (ABC) pathway for AF in China. Future economic evaluation alongside randomized clinical trials is highly warranted to verify the suggestion and investigate affecting factors such as geographical variations in patient characteristics, identification of subgroups, and constraints on local implementation.
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Affiliation(s)
- Xueyan Luo
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- School of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Wei Xu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjin, China
| | - Wai-Kit Ming
- Department of Infectious Diseases and Public Health, City University of Hong Kong, Hong Kong, Hong Kong
| | - Xinchan Jiang
- School of Pharmacy, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Quan Yuan
- Chong Qing Pharmaceutical Group Co Ltd, Chongqing, China
| | - Han Lai
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Chunji Huang
- School of Basic Medical Science, Army Medical University, Chongqing, China
| | - Xiaoni Zhong
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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22
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Guo R, Hou M, Han Y, Feng XL. Access, charge and quality of tele-dermatology e-consults in China: A standardized patients study. Digit Health 2022; 8:20552076221140763. [PMID: 36465986 PMCID: PMC9716584 DOI: 10.1177/20552076221140763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVE Direct-to-consumer telemedicine is rapidly changing the way that patients seek medical care. This study provided the first report on access, cost and quality of text- and image-based tele-dermatology e-consults, in China. METHODS We adopted the Standardized Patients approach to evaluate the services of tele-dermatology e-consults in two metropolitan cities, that is, Beijing and Hangzhou, in China. We measured quality from four dimensions: service process, diagnosis accuracy, prescription and treatment comprehensiveness, based on China's national clinical guidelines. We performed logistic regressions to investigate factors that were associated with high-quality care. RESULTS For 114 physicians eligible for inclusion, we succeeded in 87 (76%) validated visits. The median waiting time was 100 minutes (IQR 19-243 minutes) and the median length of consultation was 636 minutes (about 10 hours, IQR 188-1528 minutes). Per visit costs varied from $0 to $38, with a median of $8 (IQR 4-9). Among all, 15% of visits showed high quality in service process, 84% arrived in the correct diagnosis, 24% provided high-quality prescriptions and 71% provided comprehensive treatment. Providing images was associated with high quality in service process (OR 7.22, 95% CI 1.49-34.88). Visits in metropolitan Beijing and on non-work days had better prescription quality than that in metropolitan Hangzhou (OR 6.05, 95% CI 1.75-20.95) and that on workdays (OR 3.75, 95%CI 1.27-11.04), respectively. CONCLUSIONS Tele-dermatology e-consults seem to be easy to access and less expensive in China. However, great efforts are warranted to ensure that service processes and prescriptions adhere to clinical guidelines.
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Affiliation(s)
- Rui Guo
- School of Public Health, Capital Medical University, Beijing, China
| | - Mengchi Hou
- China Aerospace Science & Industry Corporation 731 Hospital, Beijing, China
| | - Yangyang Han
- Beijing Chinese Medical Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xing Lin Feng
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, China
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23
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Cui W, Zhu W, Li X, Wu D, He P, Yu G. Attitudes and perspectives of 534 Chinese pediatricians toward internet hospitals. Front Pediatr 2022; 10:948788. [PMID: 36245742 PMCID: PMC9554531 DOI: 10.3389/fped.2022.948788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Internet hospitals introduced in China have effectively reduced service time and space, promoted high-quality pediatric medical resources to grassroots areas, solved the contradiction between supply and demand of pediatric medical resources, and met patients' increasing multi-level and diversified medical service needs. However, pediatricians' attitudes toward and satisfaction with the use of internet hospitals remain unknown. OBJECTIVE This study aimed to investigate pediatricians' knowledge of, use of, and satisfaction with internet hospitals in order to identify major issues in internet hospital development, and to understand pediatricians' attitudes and opinions on the construction, development, and use of internet hospitals. MATERIALS AND METHODS A total of 625 pediatricians in 17 public tertiary hospitals in Shanghai were surveyed from November 1-30, 2021. Five hundred and thirty four pediatricians completed the survey, and the response rate was 85.44%. Pediatricians' baseline demographic data were collected and information about their use of and satisfaction with internet hospitals. RESULTS About 70.22% (375/534) of pediatricians knew about internet hospitals and about 54.68% (292/534) use internet hospitals for patient consultation, diagnosis, and treatment. Utilized services mainly focused on online consultation (271/292, 92.81%), online follow-up consultation (174/292, 59.59%), and health sciences (111/292, 38.01%). Online services were provided by 69.18% (202/292) of pediatricians for less than 1 h a day, and 75.00% (219/292) responded to fewer than five patient consultations online every day. Pediatricians' overall satisfaction with internet hospitals was low (3.59 ± 0.92 points), user experience, systems functions, operation processes, service prices, and performance rewards of internet hospitals were main influencing factors. Pediatricians are enthusiastic about further development of internet hospitals, with 87.83% (469/534) willing to provide services on the internet hospital platform. CONCLUSION Most pediatricians view internet hospitals favorably and are eager to contribute to the development of online diagnosis and treatment services. The development of internet hospitals will be more strongly supported by improving pediatricians' satisfaction and mobilizing their enthusiasm and initiative to participate in internet medical services.
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Affiliation(s)
- Wenbin Cui
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Hospital Development Center, Shanghai, China
| | - Weijun Zhu
- Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojie Li
- Shanghai Hospital Development Center, Shanghai, China
| | - Danmai Wu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping He
- Shanghai Hospital Development Center, Shanghai, China
| | - Guangjun Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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24
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Xiong Z, Zhang L, Li Z, Xu W, Zhang Y, Ye T. Frequency of Online Health Information Seeking and Types of Information Sought Among the General Chinese Population: Cross-sectional Study. J Med Internet Res 2021; 23:e30855. [PMID: 34860676 PMCID: PMC8686457 DOI: 10.2196/30855] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/08/2021] [Accepted: 10/29/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The internet is one of the most popular health information resources, and the Chinese constitute one-fifth of the online users worldwide. As internet penetration continues to rise, more details on the Chinese population seeking online health information need to be known based on the current literature. OBJECTIVE This study aims to explore the sociodemographic differences in online health information seeking (OHIS), including the frequency of OHIS and the types of online health information sought among the general Chinese population in mainland China. METHODS A cross-sectional study for assessing the residents' health care needs with self-administered questionnaires was implemented in 4 counties and districts in China from July 2018 to August 2018. Pearson's chi-square test was used to identify the sociodemographic differences between infrequent and frequent online health information seekers. We also performed binary logistic regression for the 4 types of online health information as the dependent variables and the sociodemographic factors as the independent variables. RESULTS Compared with infrequent online health information seekers, frequent seekers were more likely to be female (infrequent: 1654/3318; 49.85%; frequent: 1015/1831, 55.43%), older (over 60 years old; infrequent: 454/3318, 13.68%; frequent: 282/1831, 15.40%), married (infrequent: 2649/3318, 79.84%; frequent: 1537/1831, 83.94%), and better educated (bachelor's or above; infrequent: 834/3318, 25.14%; frequent: 566/1831, 30.91%). They were also more likely to earn a higher income (over RMB ¥50k [RMB ¥1=US $0.15641]; infrequent: 1139/3318, 34.33%; frequent: 710/1831, 34.78%), have commercial health insurance (infrequent: 628/3318, 18.93%; frequent: 470/1831, 25.67%), and have reported illness in the past 12 months (infrequent: 659/3318, 19.86%; frequent: 415/1831, 22.67%). Among the 4 health information types, health science popularization was the most searched for information by Chinese online health information seekers (3654/5149, 70.79%), followed by healthy behaviors (3567/5149, 69.28%), traditional Chinese medicine (1931/5149, 37.50%), and medical concerns (1703/5149, 33.07%). The binary logistic regression models showed that males were less likely to seek information on healthy behaviors (adjusted odds ratio [AOR] 0.69, 95% CI 0.61-0.78) and traditional Chinese medicine (AOR 0.64, 95% CI 0.57-0.73), and respondents who had at least 1 chronic disease were more likely to seek information on medical concerns (AOR 1.27, 95% CI 1.07-1.51) and traditional Chinese medicine (AOR 1.26, 95% CI 1.06-1.49). CONCLUSIONS Sociodemographic factors were associated with the frequency of OHIS and types of information sought among the general Chinese population. The results remind providers of online health information to consider the needs of specific population groups when tailoring and presenting health information to the target population.
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Affiliation(s)
- Zihui Xiong
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Liang Zhang
- School of Political Science and Public Administration, Wuhan University, Wuhan, China
| | - Zhong Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Wanchun Xu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Yan Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
| | - Ting Ye
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Research Center for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, China
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25
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Wang Y, Zhang H, Yang Y, Zhang Z, Guo Z. Contingency Measures During the COVID-19 Pandemic in China: An Analysis Based on a New Ethical Framework. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:28-30. [PMID: 34313576 DOI: 10.1080/15265161.2021.1940364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Yuming Wang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Hospital of Henan University
| | - Hui Zhang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Hospital of Henan University
- Zhengzhou University
| | - Yongguang Yang
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Hospital of Henan University
| | | | - Zhiping Guo
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Hospital of Henan University
- Fuwai Central China Cardiovascular Hospital
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