The quality of telemedicine consultations for sexually transmitted infections in China

被引：2

作者：

Si, Yafei ^{[1
,2
,3
,4
]}

Xue, Hao ^{[5
]}

Liao, Huipeng ^{[4
]}

Xie, Yewei ^{[4
,6
]}

Xu, Dong ^{[7
,8
,9
]}

Smith, M. Kumi ^{[10
]}

Yip, Winnie ^{[11
]}

Cheng, Weibin ^{[12
,13
]}

Tian, Junzhang ^{[12
]}

Tang, Weiming ^{[4
,12
,14
]}

Sylvia, Sean ^{[15
,16
,17
]}

机构：

[1] Zhejiang Univ, Ctr Int Studies Dev & Governance, 688 Yuhangtang Rd, Hangzhou 310058, Zhejiang, Peoples R China

[2] Univ New South Wales, Sch Risk & Actuarial Studies, 223 Anzac Parade, Kensington, NSW 2033, Australia

[3] Duke Kunshan Univ, Global Hlth Res Ctr, 8 Duke Ave, Kunshan 215316, Jiangsu, Peoples R China

[4] Univ North Carolina Project China, 313 Huanshizhong Rd, Guangzhou 510000, Guangdong, Peoples R China

[5] Stanford Univ, Stanford Ctr Chinas Inst & Econ, 16 Jane Stanford Way, Stanford, CA 94305 USA

[6] Duke NUS Med Sch, Programme Hlth Serv & Syst Res, Coll Rd, Singapore 169857, Singapore

[7] Southern Med Univ, Ctr World Hlth Org Studies, 1023 South Shatai Rd, Guangzhou 510515, Guangdong, Peoples R China

[8] Southern Med Univ, Sch Hlth Management, Dept Hlth Management, 1023 South Shatai Rd, Guangzhou 510515, Guangdong, Peoples R China

[9] Southern Med Univ SMU, Dermatol Hosp, SMU Inst Global Hlth SIGHT, Acacia Labs, 1023 South Shatai Rd, Guangzhou 510515, Guangdong, Peoples R China

[10] Univ Minnesota Twin Cities, Div Epidemiol & Community Hlth, 1300 South 2nd St, Minneapolis, MN 55454 USA

[11] Harvard Univ, Dept Global Hlth & Populat, 665 Huntington Ave, Cambridge, MA 02115 USA

[12] Guangdong Second Prov Gen Hosp, Inst Healthcare Artificial Intelligence Applicat, 66 Xingangzhong Rd, Guangzhou 510330, Guangdong, Peoples R China

[13] City Univ Hong Kong, Sch Data Sci, Kowloon, Chee Ave, Hong Kong 0000, Peoples R China

[14] Univ North Carolina Chapel Hill, Inst Global Hlth & Infect Dis, 23 Franklin St, Chapel Hill, NC 27516 USA

[15] Univ North Carolina Chapel Hill, Dept Hlth Policy & Management, 1101 McGavran Greenberg Hall, Chapel Hill, NC 27516 USA

[16] Univ North Carolina Chapel Hill, Carolina Populat Ctr, 123 Franklin St, Chapel Hill, NC 27516 USA

[17] Univ North Carolina Chapel Hill, Cecil G Sheps Ctr Hlth Serv Res, 5 MLK Jr Blvd, Chapel Hill, NC 27516 USA

来源：

HEALTH POLICY AND PLANNING | 2024年 / 39卷 / 03期

关键词：

Quality of care; direct-to-consumer telemedicine; sexually transmitted infections; standardized patient; HEALTH-CARE; STANDARDIZED-PATIENT; REPUTATION; PHYSICIAN; GENDER; TRENDS; URBAN;

D O I：

10.1093/heapol/czad119

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

The burden of sexually transmitted infections (STIs) continues to increase in developing countries like China, but the access to STI care is often limited. The emergence of direct-to-consumer (DTC) telemedicine offers unique opportunities for patients to directly access health services when needed. However, the quality of STI care provided by telemedicine platforms remains unknown. After systemically identifying the universe of DTC telemedicine platforms providing on-demand consultations in China in 2019, we evaluated their quality using the method of unannounced standardized patients (SPs). SPs presented routine cases of syphilis and herpes. Of the 110 SP visits conducted, physicians made a correct diagnosis in 44.5% (95% CI: 35.1% to 54.0%) of SP visits, and correctly managed 10.9% (95% CI: 5.0% to 16.8%). Low rates of correct management were primarily attributable to the failure of physicians to refer patients for STI testing. Controlling for other factors, videoconference (vs SMS-based) consultation mode and the availability of public physician ratings were associated with higher-quality care. Our findings suggest a need for further research on the causal determinants of care quality on DTC telemedicine platforms and effective policy approaches to promote their potential to expand access to STI care in developing countries while limiting potential unintended consequences for patients.

引用

页码：307 / 317

页数：11

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