EFFICACY EVALUATION OF TELEMEDICINE-BASED BIOPSYCHOSOCIAL MODEL: A RETROSPECTIVE STUDY IN CENTRAL CHINA
Authors: Shu Jinping , Xia Qing , Zhou Dian 
Published: July 2022

Abstract

Background
With the development of network technology, telemedicine model plays an increasingly important role as a supplement to the traditional medicine, especially during the period of Novel coronavirus pneumonia (NCP, 2019-nCoV) to reduce inter-hospital cross-infection. Remote consultation enables the consultations between a doctor and a patient to be held from distance, facilitating patients’ medical treatment and improving their adherence. However, some patients are reluctant to use it for psychological reasons such as distrust. This study aims to evaluate the effecacy of remote consultation from a psychological point of view, and then analyze patients’ satisfaction on remote consultation.

Subjects and Methods
A retrospective study was implemented, which relied on the remote consultation system of the First Affiliated Hospital of Anhui Medical University. Three county district hospitals (i.e., Jinzhai County People’s Hospital, Huoshan County Hospital, and jinzhai County Hospital of Chinese Medicine) and their subordinate township hospitals in Lu’an areas were chosen as the investigated hospitals for Questionnaire Survey. Jinzhai County Hospital was selected as the sample hospital for studying the clinical efficacy. Data were collected through questionnaire surveys. Statistical descriptions and comparisons were conducted to explore participants’ satisfaction on remote consultation, and to evaluate the different effect of remote consultation on clinical benefits, economic as well as social benefits between participants with and without a remote consultation.

Results
1. The comparison study showed that patients who used remote consultation had shorter hospitalization days, higher diagnosis coincidence rate, and higher treatment effectiveness rate than those who did not (t = –4.80, P&lt;0.05; t=2.84, P&lt;0.05; χ2= 180.20, P&lt;0.05; χ2= 144.21, P&lt;0.05). 2. Statistical data study revealed some economical costs were spared by using remote consultation, including 4,799,000 RMB in patient costs, 179,100 and RMB in transportation costs, 1,484,300 RMB in accommodation costs, and 12,873,100 RMB in social compensation funds. 3. The overall internal correspondence of the questionnaire was 0.761 (each dimension alpha was from 0.745 to 0.955). The patients’ overall satisfaction was 0.81, and the overall satisfaction score of the service attitude, consultation process, and service environment were 0.78, 0.65, and 0.85, respectively. 60.8% of patients were willing to use remote consultation again, and 60.8% of patients were willing to introduce friends.

Conclusions
Telemedicine yield beneficial effects in terms of clinical and financial contribution. First, patients can get better diagnosis and treatment, including shorter hospitalization days, higher diagnostic accuracy and better treatment effectiveness. Second, patients’ medical costs were reduced and social compensation funds were saved, producing a positive influence on health, society and economies of scale with large-scale use. Third, patients felt satisfied and were more compliant with telemedicine.

Acknowledgements
Supported by a project grant from the Major special project of science and Technology Department of Anhui Province (Grant No.16030901061).