School of Business, Yonsei University, Seoul, Republic of Korea.
JMIR Public Health Surveill. 2022 Jan 7;8(1):e31066. doi: 10.2196/31066.
Despite worldwide efforts, control of COVID-19 transmission and its after effects is lagging. As seen from the cases of SARS-CoV-2 and influenza, worldwide crises associated with infections and their side effects are likely to recur in the future because of extensive international interactions. Consequently, there is an urgent need to identify the factors that can mitigate disease spread. We observed that the transmission speed and severity of consequences of COVID-19 varied substantially across countries, signaling the need for a country-level investigation.
We aimed to investigate how distancing-enabling information and communications technology (ICT) infrastructure and medical ICT infrastructure, and related policies have affected the cumulative number of confirmed cases, fatality rate, and initial speed of transmission across different countries.
We analyzed the determinants of COVID-19 transmission during the relatively early days of the pandemic by conducting regression analysis based on our data for country-level characteristics, including demographics, culture, ICT infrastructure, policies, economic status, and transmission of COVID-19. To gain further insights, we conducted a subsample analysis for countries with low population density.
Our full sample analysis showed that implied telehealth policy, which refers to the lack of a specific telehealth-related policy but presence of a general eHealth policy, was associated with lower fatality rates when controlled for cultural characteristics (P=.004). In particular, the fatality rate for countries with an implied telehealth policy was lower than that for others by 2.7%. Interestingly, stated telehealth policy, which refers to the existence of a specified telehealth policy, was found to not be associated with lower fatality rates (P=.30). Furthermore, countries with a government-run health website had 36% fewer confirmed cases than those without it, when controlled for cultural characteristics (P=.03). Our analysis further revealed that the interaction between implied telehealth policy and training ICT health was significant (P=.01), suggesting that implied telehealth policy may be more effective when in-service training on ICT is provided to health professionals. In addition, credit card ownership, as an enabler of convenient e-commerce transactions and distancing, showed a negative association with fatality rates in the full sample analysis (P=.04), but not in the subsample analysis (P=.76), highlighting that distancing-enabling ICT is more useful in densely populated countries.
Our findings demonstrate important relationships between national traits and COVID-19 infections, suggesting guidelines for policymakers to minimize the negative consequences of pandemics. The findings suggest physicians' autonomous use of medical ICT and strategic allocation of distancing-enabling ICT infrastructure in countries with high population density to maximize efficiency. This study also encourages further research to investigate the role of health policies in combatting COVID-19 and other pandemics.
尽管全球各国都在努力，但 COVID-19 的传播及其后续影响仍难以控制。从 SARS-CoV-2 和流感的案例中可以看出，由于国际间广泛的互动，未来与感染及其副作用相关的全球危机很可能会再次发生。因此，迫切需要确定可以减轻疾病传播的因素。我们观察到，COVID-19 在各国的传播速度和后果严重程度存在显著差异，这表明需要进行国家层面的调查。
我们旨在调查支持隔离的信息和通信技术（ICT）基础设施和医疗 ICT 基础设施，以及相关政策如何影响不同国家的确诊病例累计数量、死亡率和初始传播速度。
我们通过对包括人口统计学、文化、ICT 基础设施、政策、经济状况和 COVID-19 传播在内的国家层面特征进行回归分析，在疫情早期阶段分析 COVID-19 传播的决定因素。为了获得更深入的见解，我们对人口密度较低的国家进行了子样本分析。
我们的全样本分析表明，在控制文化特征的情况下，隐含远程医疗政策（指缺乏特定的远程医疗相关政策但存在一般的电子健康政策）与较低的死亡率相关（P=.004）。特别是，具有隐含远程医疗政策的国家的死亡率比其他国家低 2.7%。有趣的是，明确的远程医疗政策（指存在特定的远程医疗政策）与较低的死亡率无关（P=.30）。此外，在控制文化特征的情况下，拥有政府运营的健康网站的国家的确诊病例比没有该网站的国家少 36%（P=.03）。我们的分析还表明，隐含远程医疗政策和培训 ICT 健康之间的相互作用具有统计学意义（P=.01），这表明在为卫生专业人员提供 ICT 在职培训时，隐含远程医疗政策可能更有效。此外，信用卡的拥有情况，作为电子商务交易和隔离的便利手段，在全样本分析中与死亡率呈负相关（P=.04），但在子样本分析中不相关（P=.76），这表明在人口密度较高的国家，支持隔离的 ICT 更为有用。
我们的研究结果表明，国家特征与 COVID-19 感染之间存在重要关系，为政策制定者提供了减轻大流行负面影响的指导方针。研究结果表明，在人口密度较高的国家，医生应自主使用医疗 ICT，并战略性地分配支持隔离的 ICT 基础设施，以实现效率最大化。本研究还鼓励进一步研究健康政策在抗击 COVID-19 和其他大流行中的作用。
