Different Roles of Telehealth and Telemedicine on Medical Tourism: An Empirical Study from Azerbaijan

Role of Telemedicine and Telehealth in Public Healthcare Sector: A Narrative Review

Clinicians, researchers in health services, and other experts have been investigating how to improve healthcare using advanced computer and telecommunication technology for more than 30 years. Adequate medical facilities are still lacking in many places of the world. In these kinds of situations, technology can be quite helpful in expanding healthcare access to rural locations and offering better care at a lower cost. The delivery of healthcare is changing dramatically because of telemedicine and telehealth, particularly in terms of improving access to care. This paper aims to provide an update on the history, background, applications, benefits, barriers, and challenges of these recent technologies. This review article also covers the healthcare conditions of rural as well as urban communities. Furthermore, the implications of technologies used and improvement in the health status of an individual are also discussed. During the COVID-19 epidemic, telehealth quickly gained popularity, bringing to light a number of issues. Effective primary medical networks are crucial, as the COVID-19 pandemic highlighted the need for improving public health responses during crises and revealed the existing fragmentation in healthcare delivery systems.

Perception, willingness, and practices of telemedicine in patients with chronic diseases: implication of digital health in patients' perspective at a tertiary care hospital in Ethiopia

Background

Technology-based healthcare services have important implications for the diagnosis, prevention, and treatment of diseases, as well as providing access to high-quality care that both the patient and the healthcare practitioner can benefit from. To access medical information, patients have also searched for methods of technology-based healthcare services like telemedicine (TM). However, little is known regarding the perceptions, willingness, and practices of TM among Ethiopian patients, especially in the study setting.

Objective

This study assessed the perceptions, willingness, and practice of TM among patients with chronic disease at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia.

Methods

A cross-sectional study was conducted from June 1 to July 30, 2022, among patients with chronic diseases who were on follow-up at the UoGCSH. Eligible participants were included in the study using a systematic random sampling technique. A structured questionnaire was used and recorded in the Kobo data collection tool. The collected data were managed and analyzed using the Statistical Package for Social Science (SPSS) version 26.

Results

Out of 422 patients approached, 384 (91% response rate) were included in the final analysis. The mean (±SD) age of the participants was 48.07 ± 16.17 years. The overall perceptions mean (±SD) score of the respondents was 3.92 ± 1.06. Generally, near to three-fourths (71.1%) of the participants had a positive perception of TM services, and around two-thirds (63.3%) had a willingness to be involved in the TM service. However, only around one-fourth (24.5%) of the participants were perceived to have a high level of TM practice currently.

Conclusion

The findings suggest that although the level of perception and willingness of TM services among patients with chronic diseases was positive, their level of practice was low. Therefore, creating awareness and suitable conditions to improve their utilization of TM could be important.

Telemedicine and direct to consumer advertising attitudes and the future of telehealth: Women report telemedicine as a comfortable option for accessing birth control

PURPOSE

This paper addresses what variables predict and mediate relationships involving accessing telemedicine in the form of online birth control websites that are often advertised online on social media.

BASIC PROCEDURES

This is a survey study of N = 252 under 60 women (Mage = 24.71); multiple linear regression and mediation analyses were done to examine the influence of IBM variables on behavioral intentions.

MAIN FINDINGS

Women who currently use contraceptives report comfort and likelihood to use telemedicine services if they have positive attitudes about telemedicine and DTC advertising. Comfort with using an online contraceptive prescription service mediated the relationship between contraceptive use and likelihood to use telemedical services and between positive telemedicine attitudes and likelihood.

PRINCIPAL CONCLUSIONS

Women who are positive about telemedicine and DTC ads are comfortable using these resources, and comfort is a salient mediator. Comfort and its antecedents are important predictors and facilitators of telemedicine intentions and behaviors. Using telemedicine can improve the patient experience by offering alternatives to face-to-face visits (i.e., removing barriers to provider-to-patient communication).

Interplay between Networking Capability and Hospital Performance in Indonesia's Medical Tourism Sector

Medical tourism is an industry that is currently developing, but research that focuses on the analysis of supply and institutions as a unit in Indonesia is sparse. This research aims to investigate the variables of digital transformation and resource integration that influence hospital performance, considering the expansion of hospitals' capacities for networking in medical tourism. A structural equation model is used to evaluate the hypothesis. According to our findings, digital transformation and resource integration both have a beneficial effect on networking capabilities. On the other hand, the implementation of digital transformation does not improve hospital performance. Digital transformation has a good link with hospital performance but has no statistically significant effect on hospital performance. In the meantime, the capabilities of resource integration and networking have a positive effect on the overall operation of hospitals. In a similar vein, the ecosystem of medical tourism helps to improve the connection between a hospital's networking capabilities and its overall performance. It is anticipated that the findings of this study will serve as a reference for those in the policymaking and healthcare industries to develop medical tourism.

Investigating revisit intention of medical tourists in China through nutritional knowledge, perceived medical quality, and trust in the physiologist: A recommendation on health tourism policy measures

Good medical care has long been a top priority in health tourism to keep the flow of visitors coming for medical treatment. Medical tourism encompasses a range of treatments, from basic check-ups to surgical operations. For its friendly character and high quality of service, China has earned a reputation as one of Asia's top destinations for health tourism. Along with India and Taiwan, Japan, Thailand, and South Korea are China's top tourism destinations. Considering the above fact, this study aims to examine the influence of nutritional knowledge, perceived medical quality, and trust in physiologists on revisiting the intention of medical tourists in China. This study is cross-sectional and follows a quantitative approach. The researchers used questionnaires as a survey tool to obtain information from the respondents. The respondents of this chosen international tourists in China who come for medical treatment purposes. A systematic random sampling technique was used to select the respondents, and 315 usable responses were collected from the respondents and proceeded with further analysis. The study conducted structural equation modeling using Smart PLS version 3. The results found that nutritional knowledge, perceived medical quality, and trust in physiologists significantly influence the revisit intention of medical tourists in China.

Diagnostic Policies Optimization for Chronic Diseases Based on POMDP Model

During the process of disease diagnosis, overdiagnosis can lead to potential health loss and unnecessary anxiety for patients as well as increased medical costs, while underdiagnosis can result in patients not being treated on time. To deal with these problems, we construct a partially observable Markov decision process (POMDP) model of chronic diseases to study optimal diagnostic policies, which takes into account individual characteristics of patients. The objective of our model is to maximize a patient’s total expected quality-adjusted life years (QALYs). We also derive some structural properties, including the existence of the diagnostic threshold and the optimal diagnosis age for chronic diseases. The resulting optimization is applied to the management of coronary heart disease (CHD). Based on clinical data, we validate our model, demonstrate how the quantitative tool can provide actionable insights for physicians and decision makers in health-related fields, and compare optimal policies with actual clinical decisions. The results indicate that the diagnostic threshold first decreases and then increases as the patient’s age increases, which contradicts the intuitive non-decreasing thresholds. Moreover, diagnostic thresholds were higher for women than for men, especially at younger ages.

Inter-Regional Hospital Patients' Mobility in Italy

Background: The federalization of the Italian National Health Service (NHS) gave administrative, financial, and managerial independence to regions. They are in reciprocal competition according to the “quasi-market” model. A network of independent providers replaced the state monopoly. The NHS, based on the Beveridge model in which citizens are free to choose their place of treatment, was consolidated. The aim of our research was to analyze the fulfillment of need for hospital services on site and patients’ migration to hospitals of other regions. Material and Methods: We analyzed data from 2013 to 2017 of Hospital Discharge Cards (HDCs) provided by the Ministry of Health. The subjects of the analysis (catchment areas) were the hospital networks of every Italian region. The study of flows was developed through Internal Demand Satisfaction, Attraction, Escape, Attraction, Absorption, and Escape Production indexes. Graphic representations were produced using Gandy’s Nomogram and Qgis software. Results: In the studied period, the mean number of mobility admission was 678.659 ± 3.388, with an increase of 0.90%; in particular, the trend for ordinary regime increased 1.17%. Regions of central/northern Italy have attracted more than 60% of the escapes of the southern ones. Gandy’s Nomogram showed that only nine regions had optimal public hospital planning (Lombardy, Autonomous Province of Bolzano, Veneto, Friuli V.G., Emilia-Romagna, Tuscany, Umbria, Latium and Molise). Conclusion: The central/northern regions appear more able to meet the care needs of their citizens and to attract patients than the southern ones.

Privacy-Preserving Authentication Protocol for Wireless Body Area Networks in Healthcare Applications

Mobile healthcare service has become increasingly popular thanks to the significant advances in the wireless body area networks (WBANs). It helps medical professionals to collect patient's healthcare data remotely and provides remote medical diagnosis. Since the health data are privacy-related, they should provide services with privacy-preserving, which should consider security and privacy at the same time. Recently, some lightweight patient healthcare authentication protocols were proposed for WBANs. However, we observed that they are vulnerable to tracing attacks because the patient uses the same identifier in each session, which could leak privacy-related information on the patient. To defeat the weakness, this paper proposes a privacy-preserving authentication protocol for WBANs in healthcare service. The proposed protocol is only based on one-way hash function and with exclusive-or operation, which are lightweight operations than asymmetric cryptosystem operations. We performed two rigorous formal security proofs based on BAN logic and ProVerif tool. Furthermore, comparison results with the relevant protocols show that the proposed protocol achieves more privacy and security features than the other protocols and has suitable efficiency in computational and communicational concerns.