Tripartite Data Analysis for Optimizing Telemedicine Operations: Evidence from Guizhou Province in China

Abstract

Telemedicine is an innovative approach that helps alleviate the health disparity in developing countries and improve health service accessibility, affordability, and quality. Few studies have focused on the social and organizational issues involved in telemedicine, despite in-depth studies of and significant improvements in these technologies. This paper used evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the implementation and operation of telemedicine. Further, numerical simulation was carried out to develop management strategies for promoting telemedicine as a new way of delivering health services. The results showed that: (1) When the benefits are greater than the costs, the higher medical institutions (HMIs), primary medical institutions (PMIs), and patients positively promote telemedicine with benign interactions; (2) when the costs are greater than the benefits, the stability strategy of HMIs, PMIs, and patients is, respectively, ‘no efforts’, ‘no efforts’, and ‘non-acceptance’; and (3) promotion of telemedicine is influenced by the initial probability of the ‘HMI efforts’, ‘PMI efforts’, and ‘patients’ acceptance’ strategy chosen by the three stakeholders, telemedicine costs, and the reimbursement ratio of such costs. Based on theoretical analysis, in order to verify the theoretical model, this paper introduces the case study of a telemedicine system integrated with health resources at provincial, municipal, county, and township level in Guizhou. The findings of the case study were consistent with the theoretical analysis. Therefore, the central Chinese government and local governments should pay attention to the running cost of MIs and provide financial support when the costs are greater than the benefits. At the same time, the government should raise awareness of telemedicine and increase participation by all three stakeholders. Lastly, in order to promote telemedicine effectively, it is recommended that telemedicine services are incorporated within the scope of medical insurance and the optimal reimbursement ratio is used.

The Egyptian Transition towards Telemedicine during the COVID-19 Pandemic: Cross-Sectional Survey

“…As regards development of the TM services on a national level, a recent study published 2020 have found that reduction of TM fees and raising of physicians' payment from 0.7 to 0.8 ratio would help improving the service (12). That are close to what we are recommending since 88.9% of the doctors participating in our study wasn't paid for their TM services.…”

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

“…The average bed occupancy rate of the investigated THCs in the present study was 63.42%, which was similar to that in the national yearbook of health statistics (61.3% in 2017 on the national range). This figure was significantly lower than that of the general hospitals (86.0% in 2017 in yearbook), especially the tertiary hospitals in urban areas (98.6%) [28], indicating the gap of the resource utilization between the general hospitals and the rural health facilities. We found that telemedicine would increase the bed occupancy rate of the THCs by about 6% in the overall sample in the present study.…”

“…In 2007, the telemedicine network of Gansu Province was founded, which covered all of the municipal hospitals, county hospitals as well as the THCs in the province [26]. With the development of medical informatization, the expansion of the service platform of telemedicine to the THCs was realized in more and more provinces [27,28]. The promotion of telemedicine on the township level was considered to improve the residents' accessibility to high-quality medical service and their utilization of primary care facilities in rural areas by the policy-makers [27].…”

“…However, to our knowledge, the effect of telemedicine on the utilization of the primary care facilities in rural China has not been evaluated yet. Moreover, the majority of the empirical studies on telemedicine in China were based on the regional telemedicine practice, such as the Internet-based hospital in Guangdong province (eastern China) [27] and the telemedicine networks in Gansu province [26] and Guizhou province (western China) [28]. Few studies have investigated the nationwide penetration of telemedicine and its effect on the health care system.…”

A Tripartite Analysis of Online Healthcare Platforms: Evidence from Spring Rain Doctor in China

“…Mary et al constructed a theoretical model in which physicians' treatment choices depend on patients' characteristics and on the recent choices of nearby peers-either because there are local knowledge spillovers or because physicians want to conform to local practice patterns [38]. Yu used evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the implementation and operation of telemedicine [39]. Through these studies, game theory has the possibility to provide a new theoretical basis for future research on the healthcare.…”