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      Online medical consultation in China: Evidence from obesity doctors

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          Abstract

          Objective

          Online medical consultation (OMC) is increasingly used in China, but there have been few in-depth studies of consultation arrangements and fee structures of online doctors in China. This research assessed the consultation arrangements and fee structure of OMC in China by undertaking a case study of obesity doctors from four representative OMC platforms.

          Methods

          Detailed information, including fees, waiting time and doctor information, was collected from four obesity OMC platforms and analyzed using descriptive statistical analysis.

          Results

          The obesity OMC platforms in China shared similarities in the use of big data and artificial intelligence (AI) but differed across service access, specific consultation arrangements and fees. Big data search and AI response technologies were used by most platforms to match users with doctors and reduce doctors’ pressure. The descriptive statistical analysis showed that the higher the rank of the online doctor, the higher the online fee and the longer the wait time. Through a comparison with offline hospitals, we found online doctors’ fees exceeded offline hospital doctors’ fees by up to 90%.

          Conclusions

          OMC platforms can gain competitive advantages over offline medical institutions through the following measures: make fuller use of big data and AI technologies to provide users with longer duration, lower cost and more efficient consultation services; provide better user experience than offline medical institutions; use big data and fee advantages to screen doctors to match users’ consultation needs instead of screening by the rank of doctors only; and cooperate with commercial insurance providers to provide innovative health care packages.

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          Most cited references27

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          Epidemiology and determinants of obesity in China

          Obesity has become a major public health issue in China. Overweight and obesity have increased rapidly in the past four decades, and the latest national prevalence estimates for 2015-19, based on Chinese criteria, were 6·8% for overweight and 3·6% for obesity in children younger than 6 years, 11·1% for overweight and 7·9% for obesity in children and adolescents aged 6-17 years, and 34·3% for overweight and 16·4% for obesity in adults (≥18 years). Prevalence differed by sex, age group, and geographical location, but was substantial in all subpopulations. Strong evidence from prospective cohort studies has linked overweight and obesity to increased risks of major non-communicable diseases and premature mortality in Chinese populations. The growing burden of overweight and obesity could be driven by economic developments, sociocultural norms, and policies that have shaped individual-level risk factors for obesity through urbanisation, urban planning and built environments, and food systems and environments. Substantial changes in dietary patterns have occurred in China, with increased consumption of animal-source foods, refined grains, and highly processed, high-sugar, and high-fat foods, while physical activity levels in all major domains have decreased with increasing sedentary behaviours. The effects of dietary factors and physical inactivity intersect with other individual-level risk factors such as genetic susceptibility, psychosocial factors, obesogens, and in-utero and early-life exposures. In view of the scarcity of research around the individual and collective roles of these upstream and downstream factors, multidisciplinary and transdisciplinary studies are urgently needed to identify systemic approaches that target both the population-level determinants and individual-level risk factors for obesity in China.
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            International variations in primary care physician consultation time: a systematic review of 67 countries

            Objective To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. Design and outcome measures This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths. Data were extracted and analysed for quality, and linear regression models were constructed to examine the relationship between consultation length and health service outcomes. Results One hundred and seventy nine studies were identified from 111 publications covering 28 570 712 consultations in 67 countries. Average consultation length differed across the world, ranging from 48 s in Bangladesh to 22.5 min in Sweden. We found that 18 countries representing about 50% of the global population spend 5 min or less with their primary care physicians. We also found significant associations between consultation length and healthcare spending per capita, admissions to hospital with ambulatory sensitive conditions such as diabetes, primary care physician density, physician efficiency and physician satisfaction. Conclusion There are international variations in consultation length, and it is concerning that a large proportion of the global population have only a few minutes with their primary care physicians. Such a short consultation length is likely to adversely affect patient healthcare and physician workload and stress.
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              Effectiveness of telemedicine: a systematic review of reviews.

              To conduct a review of reviews on the impacts and costs of telemedicine services. A review of systematic reviews of telemedicine interventions was conducted. Interventions included all e-health interventions, information and communication technologies for communication in health care, Internet based interventions for diagnosis and treatments, and social care if important part of health care and in collaboration with health care for patients with chronic conditions were considered relevant. Each potentially relevant systematic review was assessed in full text by one member of an external expert team, using a revised check list from EPOC (Cochrane Effective Practice and Organisation of Care Group) to assess quality. Qualitative analysis of the included reviews was informed by principles of realist review. In total 1593 titles/abstracts were identified. Following quality assessment, the review included 80 heterogeneous systematic reviews. Twenty-one reviews concluded that telemedicine is effective, 18 found that evidence is promising but incomplete and others that evidence is limited and inconsistent. Emerging themes are the particularly problematic nature of economic analyses of telemedicine, the benefits of telemedicine for patients, and telemedicine as complex and ongoing collaborative achievements in unpredictable processes. The emergence of new topic areas in this dynamic field is notable and reviewers are starting to explore new questions beyond those of clinical and cost-effectiveness. Reviewers point to a continuing need for larger studies of telemedicine as controlled interventions, and more focus on patients' perspectives, economic analyses and on telemedicine innovations as complex processes and ongoing collaborative achievements. Formative assessments are emerging as an area of interest. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                Digit Health
                Digit Health
                DHJ
                spdhj
                Digital Health
                SAGE Publications (Sage UK: London, England )
                2055-2076
                15 June 2023
                Jan-Dec 2023
                : 9
                : 20552076231182789
                Affiliations
                [1 ]School of Political Science and Public Administration, Ringgold 12390, universityWuhan University; , Wuhan, China
                [2 ]School of EconomicsRinggold 12390, university, Peking University; , Beijing, China
                [3 ]Dong Fureng Institute of Economic and Social DevelopmentRinggold 12465, university, Wuhan University; , Wuhan, China
                [4 ]Center for Health Economics and Management, Economics and Management School, Ringgold 12390, universityWuhan University; , Wuhan, China
                [5 ]Ringgold 242517, universityAustralian National Institute of Management and Commerce; , Eveleigh, Australia
                [6 ]Newcastle Business School, Ringgold 5982, universityUniversity of Newcastle; , Newcastle, Australia
                [7 ]School of Economics and School of Management, Ringgold 12523, universityTianjin Normal University; , Tianjin, China
                [8 ]Research Institute of International Strategies, Ringgold 12385, universityGuangdong University of Foreign Studies; , Guangzhou, China
                [9 ]School of Management, Ringgold 4591, universityUniversity of Liverpool; , Liverpool, England
                Author notes
                [*]Donglei Yu, School of Political Science and Public Administration, Wuhan University, No. 299, Bayi Road, Wuchang District, Wuhan City, Hubei Province, China. Email: yudonglei@ 123456163.com
                Author information
                https://orcid.org/0000-0003-2361-7444
                Article
                10.1177_20552076231182789
                10.1177/20552076231182789
                10278408
                37342094
                5a439c18-2b41-4fac-b7d6-a292c4fb6340
                © The Author(s) 2023

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 7 March 2023
                : 1 June 2023
                Categories
                Original Research
                Custom metadata
                ts19
                January-December 2023

                artificial intelligence,charging modes,online medical consultation,obesity doctors

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