Readiness of healthcare providers for e-hospitals: a cross-sectional analysis in China before the COVID-19 period

Tao

et al. 2022

Front. Public Health

Self Cite

BackgroundThe hierarchical medical system (HMS) refers to the classification of treatment according to disease priorities based on severity and difficulty to promote the fairness of medical services for residents, which is regarded as the key to the success of medical reform in China.MethodsIn the past decade of “New Medical Reform,” the efficiency of HMS, including secondary and tertiary hospitals and primary healthcare centers (PHCs), was measured horizontally and vertically by employing the combination of an output-oriented superefficiency slack-based model-data envelopment analysis (SE-SBM-DEA) model with the Malmquist total factor productivity index (MTFP). In the second stage, the overall technical efficiency (OTE) scores were regressed against a set of environmental characteristics and several managerial factors through bootstrapping truncated regression.ResultsOn average, the OTE score in tertiary hospitals was 0.93, which was higher than that in secondary hospitals and PHCs (0.9 and 0.92, respectively). In terms of trend, the OTE of tertiary hospitals declined at first and then increased. The opposite was true of secondary hospitals, in which the APC of the OTE was 10.82 and −3.11% in early and late 2012, respectively. The PHCs generally showed a fluctuating downward trend. In the aspects of productivity, all institutions showed a downturn by an annual average rate of 2.73, 0.51, and 2.70%, respectively. There was a significant negative relationship between the ratio of outpatients to inpatients and tertiary hospitals. Additionally, the medical technical personnel per 1,000 population negatively affected PHCs. In contrast, the GDP per capita had a significantly positive effect on tertiary hospitals, and the number of beds per 1,000 population positively influenced PHCs.ConclusionThe efficiency of medical institutions at various levels in HMS was unbalanced and took the form of an “inverted pyramid.” Multilateral factors influence the efficiency of HMS, and to address it, multi-intervention packages focusing on sinking high-quality medical resources and improving healthcare capacity, and guiding hierarchical medical practice should be adopted.

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis

Tao

et al. 2022

Front. Public Health

Self Cite

“…They could turn to medical platform apps to reach these goals instead of turning to social connections. Scholars have found that reputation building strongly incentivizes doctors to use medical platform apps ( 33 ). The interviewees’ responses in our study provided further support for this suggestion.…”

Section: Discussionmentioning

confidence: 99%

Two cities, two stages in transforming society—a mixed methods study comparing doctors’ adoption of mobile apps for communication with patients in Hangzhou and Yancheng, China

Chen,

Su,

2024

Front. Public Health

ObjectivesMobile apps have become commonplace in doctor-patient communication over the last 20 years. Doctors mainly use two kinds of app, social networking apps (i.e., WeChat) and medical platform apps (i.e., Haodf). The purpose of this study was to investigate whether the attributes of social interaction in local society impact doctors’ choice of mobile apps to communicate with patients. This article addresses two research questions: (a) To what degree do doctors’ adoption patterns in different societies differ? (b) Why do doctors choose certain mobile apps to communicate with patients?MethodsThis study employed a mixed methods research design to analyze doctor’s adoption behavior patterns in two cities, Hangzhou (HZ) and Yancheng (YC), which represent two stages in transforming society. Various patterns, measured as the percentage of doctors who utilize the medical platform app of Haodf among all doctors and the average service counts per doctor, were compared in three groups of tertiary hospitals: the top ones in HZ, the average ones in HZ, and the average ones in YC. We also conducted thematic content analysis of qualitative data from semi-structured interviews with 20 purposely selected doctors in the two cities.ResultsThe percentages of doctors who have adopted the app of Haodf from the three groups of tertiary hospitals were 49.97%, 41.00%, and 32.03%, with an average service counts per doctor of 261, 182 and 39, respectively. According to the interviewees, doctors from YC are more likely to use social networking apps to communicate with patients than their HZ counterparts to maintain social connections with their relatives, friends, colleagues, and others.ConclusionThis study demonstrates that doctors’ choices of mobile apps are dependent upon social context. In traditional society, where people have close ties, the logic of using social networking apps lies in doctors’ need to maximize the utility of their knowledge by maintaining social connections with others. In modern society, where the close ties between people have gradually weakened, the logic of using medical platform apps lies in doctors’ needs for reputation marketing, either for themselves or for institutions, their affiliated departments or hospitals.

Otolaryngol.--head neck surg.

“…An evaluation system to understand such factors may help inform clinicians of patients' access to technology, digital readiness, and specific needs. Such a tool might be used to identify barriers to care and guide management 75 . Finally, bandwidth and proper equipment must be provided to underserved communities by the government and policymakers to address the digital divide 74 …”

Section: Discussionmentioning

confidence: 99%

“…Such a tool might be used to identify barriers to care and guide management. 75 Finally, bandwidth and proper equipment must be provided to underserved communities by the government and policymakers to address the digital divide. 74…”

Section: Digital Readinessmentioning

confidence: 99%

Feasibility and Cost of Telehealth Head and Neck Cancer Survivorship Care: A Systematic Review

Ravin

Armache

Campbell

et al. 2023

Objective Evaluate the feasibility and cost‐effectiveness of telehealth head and neck cancer (HNC) survivorship care. Data Sources Ovid MEDLINE, Embase, Scopus, CINAHL. Review Methods A systematic search for peer‐reviewed feasibility studies on telehealth models for HNC survivorship care published between 2005 and 2021 was conducted using the terms “head and neck cancer” and “telehealth” and their synonyms. Inclusion criteria were studies on telehealth survivorship program interventions for HNC patients with quantitative feasibility outcome measures (eg, enrollment, retention, attrition/dropout rate, adherence/task completion rate, patient satisfaction, cost). Results Thirty‐eight studies out of 1557 identified met inclusion criteria and were included for analysis. Feasibility outcomes evaluated were enrollment and attrition rates, adherence/task completion rates, patient satisfaction, and user feedback surveys in different survivorship domains. Patient enrollment ranged from 20.8% to 85.7%, while attrition ranged from 7% to 47.7%. Overall, adherence was 30.2% higher in the intervention group than in the control group (46.8% vs 16.6%). Studies with cost analysis found telehealth models of care to be statistically significantly less expensive and more cost‐efficient than the standard model of care, with a $642.30 saving per patient (n = 3). Telehealth models also substantially reduced work time saving per visit (on average, 7 days per visit). Conclusion While telehealth survivorship programs are feasible and cost‐effective and are associated with improved patient outcomes, they might not be ideal for every patient. Further investigations are needed to understand the role of telehealth in survivorship care, given the variability in study design, reporting, measures, and methodological quality.