Evidence map›Paper›PMID 39432365›Full record

ArticleJournal of medical Internet research2024

Accessibility, Cost, and Quality of an Online Regular Follow-Up Visit Service at an Internet Hospital in China: Mixed Methods Study.

Kun Wang, Wenxin Zou, Yingsi Lai, Chun Hao, Ning Liu, Xiang Ling, Xiaohan Liu, Ting Liu, Xin Yang, Chenxi Zu and 1 more

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
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  4. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kun Wang *Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China.ORCID 0009-0001-8309-9215
Wenxin Zou *School of Government, Sun Yat-sen University, Guangzhou, China.ORCID 0009-0006-3884-7292
Yingsi LaiDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China.ORCID 0000-0003-4324-5465
Chun HaoDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, Guangzhou, China.ORCID 0000-0002-9881-6504
Ning LiuSchool of Management, Lanzhou University, Lanzhou, China.ORCID 0000-0001-8399-8985
Xiang LingThird Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.ORCID 0000-0002-7215-3984
Xiaohan LiuThird Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.ORCID 0009-0003-4050-3227
Ting LiuThird Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.ORCID 0009-0004-4478-473X
Xin YangDepartment of Health Policy and Management, School of Public Health, Sun Yat-sen University, Guangzhou, China.ORCID 0009-0003-5792-2452
Chenxi Zu *Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.ORCID 0000-0002-2937-3914
Shaolong Wu *School of Government, Sun Yat-sen University, Guangzhou, China.ORCID 0000-0003-2800-4209

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTelemedicine provides remote health care services to overcome constraints of time and space in accessing medical care. Similarly, internet hospitals in China support and provide remote health care services. Due to the COVID-19 pandemic, there has been a proliferation of internet hospitals. Many new services, including online consultations and regular online follow-up visit services, can now be accessed via internet hospitals in China. However, the accessibility, cost, and quality advantages of regular online follow-up visit services remain unclear.

objectiveThis study aimed to evaluate the accessibility, costs, and quality of an online regular follow-up visit service provided by an internet hospital in China. By analyzing the accessibility, costs, and quality of this service from the supply and demand sides, we can summarize the practical and theoretical experiences.

methodsA mixed methods study was conducted using clinical records from 18,473 patients receiving 39,239 online regular follow-up visit services at an internet hospital in 2021, as well as interviews with 7 physicians, 2 head nurses, and 3 administrative staff members. The quantitative analysis examined patient demographics, diagnoses, prescriptions, geographic distribution, physician characteristics, accessibility (travel time and costs), and service hours. The qualitative analysis elucidated physician perspectives on ensuring the quality of online health care.

resultsPatients were predominantly middle-aged men with chronic diseases like viral hepatitis who were located near the hospital. The vast majority were from Guangdong province where the hospital is based, especially concentrated in Guangzhou city. The online regular follow-up visit service reduced travel time by 1 hour to 9 hours and costs by ¥6 to ¥991 (US $0.86-$141.32) depending on proximity, with greater savings for patients farther from the hospital. Consultation times were roughly equivalent between online and in-person visits. Physicians provided most online services during lunch breaks (12 PM to 2 PM) or after work hours (7 PM to 11 PM), indicating increased workload. The top departments providing online regular follow-up visit services were Infectious Diseases, Rheumatology, and Dermatology. The most commonly prescribed medications aligned with the prevalent chronic diagnoses. To ensure quality, physicians conducted initial in-person consultations to fully evaluate patients before allowing online regular follow-up visits, during which they communicated with patients to assess conditions and determine if in-person care was warranted. They also periodically reminded patients to come in person for more comprehensive evaluations. However, they acknowledged online visits cannot fully replace face-to-face care.

conclusionsTelemedicine services such as online regular follow-up visit services provided by internet hospitals must strictly adhere to fundamental medical principles of diagnosis, prescription, and treatment. For patients with chronic diseases, online regular follow-up visit services improve accessibility and reduce cost but cannot fully replace in-person evaluations. Physicians leverage various strategies to ensure the quality of online care.

Indexed as

COVID-19Health Services AccessibilityTelemedicineAdolescentAdultAgedChildChild, PreschoolChinaFemaleHumansInfantInternetMaleMiddle AgedPandemicsaccessibilitycostinternet hospitalmedical servicequalityregular follow-up

Identifiers

PMID39432365
PMCPMC11535792

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.