Correlation Between the Online Visiting Time and Frequency Increase in Telemedicine Services Offered by Health Care Providers Before, During, and After the COVID-19 Pandemic in China: Cross-Sectional Study
Authors: Wang Weiyi , Chu Yuntian , Cui Fangfang , Shi Xiaobing , Zhang Xu , Sun Dongxu , Shi Jinming , Zhao Jie 
Published: February 2025

Background
China has changed its COVID-19 prevention and control status since 2023. However, what role telemedicine will play post–COVID-19 is still uncertain.

Objective
We aimed to determine the frequency change in health care providers offering telemedicine services before, during, and after COVID-19, as well as the correlation between the frequency change and telemedicine visit time.

Methods
The Telemedicine Informationization Professional Committee of China (TIPC) carried out a nationwide questionnaire survey. We adopted data from part of the questionnaires that answered questions regarding the frequency of offering telemedicine services before, during, and after the COVID-19 explosion. Chi-square tests were applied to compare general differences in the between-group telemedicine frequency. Regression models were performed to analyze correlations between the frequency change and the time spent in online versus in-person visits.

Results
Questionnaires from 428 providers were included. As reported, 39 (9.11%) providers often and 159 (37.15%) always offered telemedicine services before COVID-19 exploded. The component ratio increased to 12.38% (n=53) of providers often and 45.79% (n=196) always offering telemedicine during COVID-19 explosion and 12.62% (n=54) often and 50% (n=214) always offering telemedicine after pandemic control was relaxed. The increase in frequency shown as a difference between the before and during groups (χ2=17.21, P.002) and between the before and after groups (χ2=30.17, P<.001) was significant, while it was insignificant between the during and after groups (χ2=2.89, P.57). Senior professional titles (odds ratio [OR] 4.38, 95% CI 1.72-11.6) and longer (OR 3.87, 95% CI 1.95-7.89) and shorter (OR 2.04, 95% CI 1.11-3.87) online visits were correlated with the increase in frequency during versus before COVID-19. In addition, senior professional titles (OR 3.47, 95% CI 1.46-8.49), longer (OR 3.14, 95% CI 1.64-6.11) and shorter (OR=2.27, 95% CI 1.31-4.07) online visits, and using third-party telemedicine platforms (OR 0.51, 95% CI 0.29-0.86) were correlated with the increase in frequency after versus before COVID-19. No factor was significantly correlated with the frequency change after versus during COVID-19. In stratified analysis, longer online visits were correlated with both during versus before (OR 3.84, 95% CI 1.73-8.83) and after versus before (OR 3.40, 95% CI 1.61-7.34) groups for providers using hospital-run platforms, while shorter online visits were correlated with both during versus before (OR 8.16, 95% CI 1.39-68.3) and after versus before (OR 5.70, 95% CI 1.22-33.6) groups for providers using third-party platforms.

Conclusions
The frequency of telemedicine has increased since the COVID-19 pandemic exploded and is correlated with the time spent in online versus in-person visits. The correlation is different for providers using hospital-run and third party platforms. On a hospital-run platform, providers with longer online visits have a higher frequency of offering telemedicine, while on a third-party platform, providers with shorter online visits are more likely to offer telemedicine.