The Association Between Telehealth Utilization and Policy Responses on COVID-19 in Japan: Interrupted Time-Series Analysis

Abstract

Background Telehealth using telephones or online communication is being promoted as a policy initiative in several countries. However, there is a lack of research on telehealth utilization in a country such as Japan that offers free access to medical care and regulates telehealth provision—particularly with respect to COVID-19. Objective The present study aimed to clarify telehealth utilization, the characteristics of patients and medical institutions using telehealth, and the changes to telehealth in Japan in order to support the formulation of policy strategies for telehealth provision. Methods Using a medical administrative claim database of the National Health Insurance and Advanced Elderly Medical Service System in Mie Prefecture, we investigated patients who used telehealth from January 2017 to September 2021. We examined telehealth utilization with respect to both patients and medical institutions, and we determined their characteristics. Using April 2020 as the reference time point for COVID-19, we conducted an interrupted time-series analysis (ITSA) to assess changes in the monthly proportion of telehealth users to beneficiaries. Results The number of telehealth users before the reference time point was 13,618, and after the reference time point, it was 28,853. Several diseases and conditions were associated with an increase in telehealth utilization. Telehealth consultations were mostly conducted by telephone and for prescriptions. The ITSA results showed a sharp increase in the proportion of telehealth use to beneficiaries after the reference time point (rate ratio 2.97; 95% CI 2.14-2.31). However, no apparent change in the trend of increasing or decreasing telehealth use was evident after the reference time point (rate ratio 1.00; 95% CI 1.00-1.01). Conclusions We observed a sharp increase in telehealth utilization after April 2020, but no change in the trend of telehealth use was evident. We identified changes in the characteristics of patients and providers using telehealth.

Treatment interruption in hypertensive patients during the COVID‐19 pandemic: An interrupted time series analysis using prescription data in Okayama, Japan

“…As shown in emergency declaration in Japan, with most telemedicine provided via telephone and for prescription purposes. 27 In our study, we focused on monthly prescriptions, regardless of whether they were inperson or via telephone; therefore, the exact proportion is unclear.…”

“…found that the proportion of telemedicine use increased approximately threefold immediately following the first COVID‐19 emergency declaration in Japan, with most telemedicine provided via telephone and for prescription purposes. 27 In our study, we focused on monthly prescriptions, regardless of whether they were in‐person or via telephone; therefore, the exact proportion is unclear. However, it is possible that telephone prescriptions contributed to the continuation of treatment during the pandemic.…”

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“…This finding is in line with a previous study conducted in Japan, where the mean age of respondents using telemedicine services was over 60 years. 12 This might be associated with the higher risk of developing chronic diseases, especially NCDs, in the aging population. 36 Most patients (65%) used telemedicine services for hypertension, DM, and mental health problems.…”

“…Patients over 65 years old used telemedicine services 3.25 times more than pre-pandemic, whereas patients under 65 years old used it 2.48 times more than pre-pandemic. 12 However, there is scarcity of information regarding the use of telemedicine service during the pandemic in Thailand. Moreover, there is limited information on the impact of COVID-19 variant outbreaks on the use of telemedicine services within Thailand and globally.…”

In-Home Monitoring Technology for Aging in Place: Scoping Review

“…This research also highlights the importance of appropriate strategies for smart home design. The emergence of telehealth and online communication can play an essential role in successful aging in place, in that this telemedicine is an effective way to address many societal issues of older adults, such as overcrowding, driving a car, and mitigating infection risks [43]. A smart home with in-home monitoring technology can provide significant information to care providers, which will be helpful for maintaining health and well-being.…”