Contracts to Coordinate Healthcare Providers in the Telemedicine Referral System

Abstract

With the help of telemedicine, healthcare providers can increase patients’ access to high-quality services while reducing the medical expenditure, especially for patients in remote areas. Once advanced care is needed, local patients will first be referred to an online health service and then be referred to the offline hospital if the online healthcare fails. In practice, local community hospitals and the advanced tertiary hospitals generally lack financial incentives to exert costly, but non-reimbursable, effort to avoid poor patient outcomes. Therefore, we build a new model to analyze the interaction between these two service providers, promoting them to exert the right effort by designing payment contracts. Our results show that neither fee-for-service nor bundled payment contracts can achieve the social optimum. Tertiary hospitals always exert less effort than the socially-optimal effort while the community hospital may exert less or more effort depending on the online treatment cost. Then, we propose a performance-based bundled payment contract that can coordinate both hospitals’ decisions to achieve socially optimal outcomes. Finally, we numerically show the impact of the referral service fee and the online treatment cost on the efficiency of these contracts.

Measuring the Impact of Virtual Communities on the Intention to Use Telemedicine Services

“…Previous studies [ 67 , 68 , 69 , 70 ] noted that the norm is the objective standard of conduct in the name of public opinion, and compliance comes from the individual’s psychological tendencies. Despite this, pressure from the group will have an effect on people’s decision making [ 71 ]. Based on this discussion, this study includes social influence as one of the factors with an impact on the intention to use telemedicine services.…”

Determining Factors Affecting the Users’ Participation of Online Health Communities: An Integrated Framework of Social Capital and Social Support

“…Management of chronic diseases outside the hospital exists as a tricky issue. Meanwhile, treatment of chronic diseases is a long-term process, which requires lifelong treatment, long-term medication and health management ( Lai et al, 2021 ; Wang et al, 2021 ; Wu H. et al, 2021 ). Under the traditional medical care model, patients need to communicate with doctors about their disease in hospital.…”

“…Internet medical care can not only reasonably serve part of patients who do not have to seek consultation in hospitals offline, but also reduce the waste of medical resources and medical fees ( Mo and Deng, 2015 ; Hossain, 2016 ). Moreover, the time cost for patients to receive medical treatment face to face is efficiently brought down, and the limited number of quality medical resources are left for those who are genuinely in need ( Feng et al, 2021 ; Wang et al, 2021 ). Online health communities (OHCs) or online health communities exist as a community for health information exchange, where users can have health consultation, experience sharing, knowledge sharing and emotional sharing ( Peng et al, 2019 ; Qiao et al, 2021 ).…”