Assessment of Internet Hospitals in China During the COVID-19 Pandemic: National Cross-Sectional Data Analysis Study (Preprint)

Abstract

BACKGROUND The Internet hospital is rapidly developing in China as an innovative approach to providing health services. The corona virus disease 2019 (COVID-19) outbreak has boost the process because Internet hospital has the ability to provide widespread accessible outpatient service delivery via Internet technologies for the public during the epidemic. To date, China's Internet hospitals during the COVID-19 pandemic have not been systematically investigated. OBJECTIVE The aim of this study is to understand the characteristics of China's Internet hospitals, and to assess their health service capacity. METHODS Using “Internet hospitals”, “Internet health”, “Internet medicine”, “mobile medicine”, “mobile health”, “Telehealth”, “digital medicine”, “digital health”, “Web hospitals”, and “Cloud hospitals” in Chinese as the search terms, the data of Internet hospitals were collected via official website, the WeChat platform, smartphone app and the Baidu search engine until July, 2020. RESULTS By July 2020, the number of Internet hospitals had expanded to 714 in 31 provinces. Of the 714 Internet hospitals, the half of Internet hospitals were established in 2019 (206, 28.85%) and 2020 (215, 30.11%). Especially, Internet hospitals set up in the beginning of 2020, as an emergency response to the COVID-19 epidemic, has a one-third weight in the final total. There are three different dominators—government-oriented, hospital-oriented, and enterprise-oriented internet hospitals—for which sponsors have different characters of supporting content and responsibilities. In the vast majority of Internet hospitals, traditional hospitals have dominant position (73.67%, 526/714). In addition, patients accessed outpatient service delivery via WeChat (224, 35.05%) most widely. 221 (46.14%) of Internet hospitals asked doctors to give health services at a specific Web clinic, while 258(53.86%) by smartphone app. The consulting methods included graphic message (96.84%), video (43.51%) and telephone (41.75%). Besides, 106(18.60%) Internet hospitals offered 3 ways to consult for patients at the same time. The median number of doctors available online was 43. The median consultation fee of fever clinic and other outpatient clinics except fever clinic per time were separately ¥0 and ¥6. Four-fifths(80.94%) of doctors were from local hospitals and medical union. Internet hospitals played various roles during COVID-19, such as medical prescription, drug delivery service, medical insurance, epidemic prevention and control information, fever clinic consultation, psychological counseling, myth busters of COVID-19, epidemic situation dynamic and donation. CONCLUSIONS Internet hospitals are booming in China. Internet hospital play an important role on preventing and controlling COVID-19, providing different and convenient types of medical services for people seeking medical needs.