Regional Heterogeneity of Application and Effect of Telemedicine in the Primary Care Centres in Rural China

Xu, Wanchun; Pan, Zijing; Shunhua, Lu; Zhang, Liang

doi:10.3390/ijerph17124531

Cited by 12 publications

(12 citation statements)

References 60 publications

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“…Township health centers, as primary care facilities that provide inpatient services, presented higher probability of PPH (22.6%) than county hospitals (7.93%). The result may be due to clinical uncertainty given the relatively lower staff capacity ( 36 ) or could be physician-induced demand as a result of a lower bed occupancy rate and economic incentives at primary care facilities ( 22 , 37 ). Patients usually bypass primary care facilities to seek health care in hospitals in China ( 21 ); therefore, lack of primary care services might be a key reason for PPHs at county hospitals.…”

Section: Discussionmentioning

confidence: 99%

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Shunhua

Zhang

Liang

et al. 2022

Front. Public Health

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IntroductionHigh-cost patients are characterized by repeated hospitalizations, and inpatient cost accounts for a large proportion of their total health care spending. This study aimed to assess the occurrence and costs of potentially preventable hospitalizations and explore contributing factors among high-cost patients in rural China.MethodsWe examined a population-based sample of patients using the 2016 New Rural Cooperative Medical Scheme in Dangyang city, China. Eighteen thousand forty-three high-cost patients were identified. A validated tool and logistic regression analysis were used to determine preventable hospitalizations and their patient-level and supply-side factors.ResultsHigh-cost patients were older (average age of 54 years) than non-high-cost patients (50 years) and more likely to come from poverty-stricken families. The occurrence of preventable hospitalization was 21.65% among high-cost patients. The proportion of preventable inpatient cost in total inpatient and outpatient expenditure among high-cost patients (5.81%) was lower than that of non-high-cost patients (7.88%) but accounted for 75.87% of the overall preventable inpatient cost. High-cost patients with more hospitalizations were more likely to experience preventable hospitalization, and those with heart failure, COPD, diabetes and mixed conditions were at a higher risk of preventable hospitalization, while those with more outpatient visits were less likely to show preventable hospitalization.ConclusionsThe occurrence of preventable hospitalization among high-cost patients in rural China was sizeable. The preventable inpatient cost of the overall population was concentrated among high-cost patients. Interventions such as improving preventive care and disease management targeting high-cost patients within counties may improve patients' health outcomes and quality of life and reduce overall preventable inpatient cost.

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Section: Discussionmentioning

confidence: 99%

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Shunhua

Zhang

Liang

et al. 2022

Front. Public Health

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“…Xu et al found that 58.66% of the township health centers in rural China applied telemedicine in 2017, and this proportion was much higher in western China, with the central region following and the lowest in the eastern region. In each region, the prevalence of telemedicine adoption also tended to be higher in the less developed province (34). During COVID-19 pandemic, it was reported that continuity of care for patients with rheumatic disease could be guaranteed through telemedicine, mainly through telephone consultations, while adoption of other forms of telemedicine, such as asynchronous communication and video consultations was still low in the Netherlands (35).…”

Section: Telemedicine Around the Worldmentioning

confidence: 99%

The Challenges of Telemedicine in Rheumatology

Song

Bernard²,

Jørgensen

et al. 2021

Front. Med.

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During the past 20 years, the development of telemedicine has accelerated due to the rapid advancement and implementation of more sophisticated connected technologies. In rheumatology, e-health interventions in the diagnosis, monitoring and mentoring of rheumatic diseases are applied in different forms: teleconsultation and telecommunications, mobile applications, mobile devices, digital therapy, and artificial intelligence or machine learning. Telemedicine offers several advantages, in particular by facilitating access to healthcare and providing personalized and continuous patient monitoring. However, some limitations remain to be solved, such as data security, legal problems, reimbursement method, accessibility, as well as the application of recommendations in the development of the tools.

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“…More specific health services are increasingly available in rural areas with telemedicine (8). Telemedicine improves patient satisfaction, especially in pediatric and rehabilitation services (9).…”

Section: Positive Impactmentioning

confidence: 99%

“…Private telemedicine network service companies, Non-Governmental Organizations (NGOs), and the government want a reasonable price to cover the costs of providing telemedicine (13). Health insurers need to estimate cost coverage for their clients by using telemedicine services (9). All research journals do not explain the standard of validity of informed consent in telemedicine that can be used as a reference in obtaining it (oral or e-form).…”

Section: A Telemedicine Policies or Standardsmentioning

confidence: 99%

Telemedicine and Electronic Health Record Implementation in Rural Area: A Literature Review

Alfiyyah¹,

Ayuningtyas²,

Rahmanto³

2022

J INDO HEALTH POLICY ADM

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The Indonesian Minister of Health 2019 issued regulations regarding the implementation of telemedicine services between health service facilities. Telemedicine is aimed primarily at rural areas. This research aims to look at the quality of telemedicine-based services, which are documented in an electronic health record (EHR) with complete information. This research uses the narrative literature review method: Garuda journal channels, Google Scholar, IEEE Explorer, ProQuest, PubMed, Science Direct, and Scopus. With the input-output process approach, eight scientific articles were published on countries with telemedicine/telehealth policies in rural areas. The implementation of telemedicine has advantages and disadvantages depending on the things supported and the target users. It must have policies, infrastructure, financial resources, and human resources to use, maintain and develop telemedicine. Telemedicine will help the health service process by increasing the degree of public health in rural areas if it is used on a large scale. The completeness of the EHR seems to be lacking in terms of informed consent. Still, a quality EHR can make it easier for health workers to enforce the history, establish the diagnosis, and provide patient healthcare.

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Regional Heterogeneity of Application and Effect of Telemedicine in the Primary Care Centres in Rural China

Cited by 12 publications

References 60 publications

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

Characterizing Potentially Preventable Hospitalizations of High-Cost Patients in Rural China

The Challenges of Telemedicine in Rheumatology

Telemedicine and Electronic Health Record Implementation in Rural Area: A Literature Review

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