Implications of Mobile Technology on Hospitalization Rates in Medically Underserved Areas Worldwide: A Systematic Review.

Hospitalizations in medically underserved areas remain a significant challenge, often driven by barriers such as limited access to healthcare services due to institutional barriers or physical facility access due to distance and transportation issues, inadequate preventive care, and a higher prevalence of chronic diseases. In recent years, mobile health (mHealth) technology has emerged as a promising tool to bridge healthcare gaps, offering innovative solutions to address these challenges by leveraging mobile devices to improve patient care, health monitoring, and engagement. However, while digital and mHealth interventions hold promise, implementing them in underserved areas presents unique challenges. This scoping review aims to assess the current landscape of mobile technology interventions in medically underserved areas, with a particular focus on their effects on hospitalization rates. A systematic review was conducted utilizing the PubMed, Embase, and CINAHL databases for the identification of articles to include within the review. After using the search terms in each database, a total of 416 articles were found to meet the search query. All articles were screened and reviewed based on the criteria, and 15 articles (n=15) were selected for review. The most commonly studied technologies were telehealth visits (n=9), while mobile apps (n=4), smart glasses (n=1), and remote patient monitoring devices (n=1) made up the remaining technologies studied. Hospitalizations were grouped as either inpatient hospitalizations (n=8), emergency department (ED) visits (n=4), or other hospital referrals in cases where a patient may be referred to a hospital but was not classified as either inpatient hospitalization or emergency. Across the emergency group studies, the experimental arm of the studies had a lower rate of ED visits and inpatient admissions. There could exist potential complications for evaluating these new digital technologies in rural and underserved populations, including level of education and cost. Additionally, while 15 articles were reviewed in this systematic review, there appears to be substantially more literature available for non-rural, non-underserved communities. Within the limited data currently available, we found reductions in inpatient admission rates and ED visits when utilizing digital technologies. Given the potential cost benefits that these technologies could provide, further investigation into this topic may be warranted.