Telehealth, medical decisions and new health inequality in China
Abstract Background The widespread of telehealth has not only improved medical service accessibility and convenience, and has also played an active role in the COVID-19 Epidemic. This suggests that telehealth is becoming increasingly important in both normality and emergency. It is therefore essenti...
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| Language: | English |
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2025-02-01
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| Online Access: | https://doi.org/10.1186/s12889-025-22039-1 |
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| author | Zhaopeng Xu Liuliu Zhou Weibang Gu Zhixin Yang Lufa Zhang |
| author_facet | Zhaopeng Xu Liuliu Zhou Weibang Gu Zhixin Yang Lufa Zhang |
| author_sort | Zhaopeng Xu |
| collection | DOAJ |
| description | Abstract Background The widespread of telehealth has not only improved medical service accessibility and convenience, and has also played an active role in the COVID-19 Epidemic. This suggests that telehealth is becoming increasingly important in both normality and emergency. It is therefore essential to evaluate the use of the technology and its impact on the healthcare system. Objective This paper studied the use of telehealth in China, the socio-demographic characteristics of users, its impact on patients’ choice of first-visit, and potential health inequalities. Methods We obtained 14,944 valid questionnaires from a multistage stratified sample of 41 cities in the Yangtze River Delta, China, and multinomial logit was mainly used. Results The utilization rate of telehealth in the study area was 10.43%. Residents that were younger, more educated, had higher household incomes, were more health literate, used more adequate medical insurance, ordered food delivery more often, and had chronic diseases were more likely to use telehealth. Residents who used telehealth had significantly higher odds of choosing high-level hospital instead of primary care provider as their first visit (B = 0.168, P < 0.05;B = 0.192, P < 0.05). And this substitution effect is more pronounced among the younger, more educated, and higher household income residents. Conclusions Telehealth is still underutilized in China’s actual healthcare services, and use of telehealth is more likely to be seen among younger, higher-income, and well-educated groups. The use of telehealth may lead residents to skip primary health care more easily and occupy secondary and tertiary health care inappropriately. It maybe impacts China’s hierarchical medical system, and further leading to new potential health inequalities due to the “digital divide”. |
| format | Article |
| id | doaj-art-5bad28c9b1ba442da03375e4eff0cf24 |
| institution | DOAJ |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-5bad28c9b1ba442da03375e4eff0cf242025-08-20T03:03:46ZengBMCBMC Public Health1471-24582025-02-0125111210.1186/s12889-025-22039-1Telehealth, medical decisions and new health inequality in ChinaZhaopeng Xu0Liuliu Zhou1Weibang Gu2Zhixin Yang3Lufa Zhang4School of International and Public Affairs, Shanghai Jiao Tong UniversityDepartment of Gastroenterology, Chongming Branch, Shanghai Tenth People’s Hospital, Tongji University School of MedicineSchool of International and Public Affairs, Shanghai Jiao Tong UniversityChongming District Changxing Town Community Health Service CenterSchool of International and Public Affairs, Shanghai Jiao Tong UniversityAbstract Background The widespread of telehealth has not only improved medical service accessibility and convenience, and has also played an active role in the COVID-19 Epidemic. This suggests that telehealth is becoming increasingly important in both normality and emergency. It is therefore essential to evaluate the use of the technology and its impact on the healthcare system. Objective This paper studied the use of telehealth in China, the socio-demographic characteristics of users, its impact on patients’ choice of first-visit, and potential health inequalities. Methods We obtained 14,944 valid questionnaires from a multistage stratified sample of 41 cities in the Yangtze River Delta, China, and multinomial logit was mainly used. Results The utilization rate of telehealth in the study area was 10.43%. Residents that were younger, more educated, had higher household incomes, were more health literate, used more adequate medical insurance, ordered food delivery more often, and had chronic diseases were more likely to use telehealth. Residents who used telehealth had significantly higher odds of choosing high-level hospital instead of primary care provider as their first visit (B = 0.168, P < 0.05;B = 0.192, P < 0.05). And this substitution effect is more pronounced among the younger, more educated, and higher household income residents. Conclusions Telehealth is still underutilized in China’s actual healthcare services, and use of telehealth is more likely to be seen among younger, higher-income, and well-educated groups. The use of telehealth may lead residents to skip primary health care more easily and occupy secondary and tertiary health care inappropriately. It maybe impacts China’s hierarchical medical system, and further leading to new potential health inequalities due to the “digital divide”.https://doi.org/10.1186/s12889-025-22039-1TelehealthMedical choiceThe hierarchical medical systemHealth inequality |
| spellingShingle | Zhaopeng Xu Liuliu Zhou Weibang Gu Zhixin Yang Lufa Zhang Telehealth, medical decisions and new health inequality in China BMC Public Health Telehealth Medical choice The hierarchical medical system Health inequality |
| title | Telehealth, medical decisions and new health inequality in China |
| title_full | Telehealth, medical decisions and new health inequality in China |
| title_fullStr | Telehealth, medical decisions and new health inequality in China |
| title_full_unstemmed | Telehealth, medical decisions and new health inequality in China |
| title_short | Telehealth, medical decisions and new health inequality in China |
| title_sort | telehealth medical decisions and new health inequality in china |
| topic | Telehealth Medical choice The hierarchical medical system Health inequality |
| url | https://doi.org/10.1186/s12889-025-22039-1 |
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