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远程医疗服务提供的决定因素:来自经合组织国家的经验证据。

The Determinants of Telehealth Provision: Empirical Evidence from OECD Countries.

机构信息

Department of Economics, College of Social Science, National Cheng Kung University, Tainan 701, Taiwan.

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.

出版信息

Int J Environ Res Public Health. 2021 Aug 5;18(16):8288. doi: 10.3390/ijerph18168288.

Abstract

Health services provided through the telecommunications system aim to improve the population's health and well-being. This research aims to explore what digital, economic, and health factors are associated with the provision of telehealth services, especially in ageing communities. Applying Organization for Economic Cooperation and Development (OECD) countries' experiences, this research tries to construct a logistic regression model between adopting a telehealth system or not, a binary outcome variable, and a group of potentially explanatory variables. Estimation results showed that there were thresholds for telehealth provision: The demand for telehealth service usually began when the provision of telecommunication accessibility reached 50%, the proportion of elders exceeded 10%, or the proportion of health spending occupied more than 3-5% of the gross domestic product (GDP); the slope of each variable seemed to correspond with an increase in demand for such a provision. A growing number of individuals in OECD countries are now readily served by telehealth systems under the COVID-19 pandemic. These findings could be regarded as a model for other countries for implementing the necessary infrastructure early on when any of these parameters reaches its threshold. Moreover, telehealth applied in developing countries could be elevated for wider populations to access basic health services and for the remote delivery of health care. A rational decision could be made to appropriately use additional resources in telehealth provision. With accessible e-health services, the population's health could be improved, which in turn would possibly increase productivity and social welfare.

摘要

通过电信系统提供的医疗服务旨在提高人口的健康和福祉。本研究旨在探索数字、经济和健康因素与远程医疗服务的提供有何关联,尤其是在老龄化社区。本研究借鉴经济合作与发展组织(OECD)国家的经验,尝试在是否采用远程医疗系统(二元因变量)和一组潜在的解释变量之间构建逻辑回归模型。估计结果表明,远程医疗服务的提供存在门槛:通常,当远程通信可达性的提供达到 50%,老年人的比例超过 10%,或医疗支出占国内生产总值(GDP)的比例超过 3-5%时,对远程医疗服务的需求就会开始;每个变量的斜率似乎都与这种服务提供的需求增加相对应。在 COVID-19 大流行期间,越来越多的经合组织国家的民众现在可以通过远程医疗系统得到服务。当这些参数中的任何一个达到其阈值时,这些发现可以被视为其他国家早期实施必要基础设施的模型。此外,在发展中国家,远程医疗的应用可以为更多人提供基本医疗服务,并实现远程医疗服务。可以做出合理的决策,适当利用远程医疗服务提供中的额外资源。通过普及电子医疗服务,可以改善人口健康,进而可能提高生产力和社会福利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/47dc/8392622/0610c3650490/ijerph-18-08288-g001.jpg

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