Kinoshita Takuya, Matsumoto Takehiro, Taura Naota, Usui Tetsuya, Matsuya Nemu, Nishiguchi Mayumi, Horita Hozumi, Nakao Kazuhiko
Department of Medical Informatics, Nagasaki University, Nagasaki, Japan.
Department of Medical Informatics, Nagasaki University Hospital, Nagasaki, Japan.
JMIR Form Res. 2022 Sep 14;6(9):e36525. doi: 10.2196/36525.
Recently, the use of telehealth for patient treatment under the COVID-19 pandemic has gained interest around the world. As a result, many infodemiology and infoveillance studies using web-based sources such as Google Trends were reported, focusing on the first wave of the COVID-19 pandemic. Although public interest in telehealth has increased in many countries during this time, the long-term interest has remained unknown among people living in Japan. Moreover, various mobile telehealth apps have become available for remote areas in the COVID-19 era, but the accessibility of these apps in epidemic versus nonepidemic regions is unknown.
We aimed to investigate the public interest in telehealth during the first pandemic wave and after the wave in the first part of this study, and the accessibility of medical institutions using telehealth in the epidemic and nonepidemic regions, in the second part.
We examined and compared the first wave and after the wave with regards to severe cases, number of deaths, relative search volume (RSV) of telehealth and COVID-19, and the correlation between RSV and COVID-19 cases, using open sources such as Google Trends and the Japanese Ministry of Health, Labour and Welfare (JMHLW) data. The weekly mean and the week-over-week change rates of RSV and COVID-19 cases were used to examine the correlation coefficients. In the second part, the prevalence of COVID-19 cases, severe cases, number of deaths, and the telehealth accessibility rate were compared between epidemic regions and nonepidemic regions, using the JMHLW data. We also examined the regional correlation between telehealth accessibility and the prevalence of COVID-19 cases.
Among the 83 weeks with 5 pandemic waves, the overall mean for the RSV of telehealth and COVID-19 was 11.3 (95% CI 8.0-14.6) and 30.7 (95% CI 27.2-34.2), respectively. The proportion of severe cases (26.54% vs 18.16%; P<.001), deaths (5.33% vs 0.99%; P<.001), RSV of telehealth (mean 33.1, 95% CI 16.2-50.0 vs mean 7.3, 95% CI 6.7-8.0; P<.001), and RSV of COVID-19 (mean 52.1, 95% CI 38.3-65.9 vs mean 26.3, 95% CI 24.4-29.2; P<.001) was significantly higher in the first wave compared to after the wave. In the correlation analysis, the public interest in telehealth was 0.899 in the first wave and -0.300 overall. In Japan, the accessibility of telehealth using mobile apps was significantly higher in epidemic regions compared to nonepidemic regions in both hospitals (3.8% vs 2.0%; P=.004) and general clinics (5.2% vs 3.1%; P<.001). In the regional correlation analysis, telehealth accessibility using mobile apps was 0.497 in hospitals and 0.629 in general clinics.
Although there was no long-term correlation between the public interest in telehealth and COVID-19, there was a regional correlation between mobile telehealth app accessibility in Japan, especially for general clinics. We also revealed that epidemic regions had higher mobile telehealth app accessibility. Further studies about the actual use of telehealth and its effect after the COVID-19 pandemic are necessary.
最近，在新冠疫情大流行期间使用远程医疗进行患者治疗在全球范围内受到关注。因此，许多利用谷歌趋势等网络资源进行的信息流行病学和信息监测研究被报道，重点关注新冠疫情的第一波。尽管在此期间许多国家民众对远程医疗的兴趣有所增加，但日本民众的长期兴趣仍不明确。此外，在新冠疫情时代，各种移动远程医疗应用程序已可供偏远地区使用，但这些应用程序在疫情地区与非疫情地区的可及性尚不清楚。
在本研究的第一部分，我们旨在调查疫情第一波期间及之后民众对远程医疗的兴趣；在第二部分，我们旨在调查疫情地区和非疫情地区使用远程医疗的医疗机构的可及性。
我们使用谷歌趋势和日本厚生劳动省（JMHLW）数据等公开来源，检查并比较了第一波及之后的重症病例、死亡人数、远程医疗和新冠的相对搜索量（RSV），以及RSV与新冠病例之间的相关性。使用RSV和新冠病例的每周均值及环比变化率来检查相关系数。在第二部分，利用JMHLW数据比较了疫情地区和非疫情地区的新冠病例患病率、重症病例、死亡人数以及远程医疗可及率。我们还研究了远程医疗可及性与新冠病例患病率之间的区域相关性。
在有5波疫情的83周中，远程医疗和新冠的RSV总体均值分别为11.3（95%CI 8.0 - 14.6）和30.7（95%CI 27.2 - 34.2）。与第一波之后相比，第一波中的重症病例比例（26.54%对18.16%；P<0.001）、死亡比例（5.33%对0.99%；P<0.001）、远程医疗的RSV（均值33.1，95%CI 16.2 - 50.0对均值7.3，95%CI 6.7 - 8.0；P<0.001）以及新冠的RSV（均值52.1，95%CI 38.3 - 65.9对均值26.3，95%CI 24.4 - 29.2；P<0.001）均显著更高。在相关性分析中，第一波中民众对远程医疗的兴趣为0.899，总体为 - 0.300。在日本，无论是医院（3.8%对2.0%；P = 0.004）还是普通诊所（5.2%对3.1%；P<0.001），疫情地区使用移动应用程序的远程医疗可及性均显著高于非疫情地区。在区域相关性分析中，医院使用移动应用程序的远程医疗可及性为0.497，普通诊所为0.629。
尽管民众对远程医疗的兴趣与新冠之间没有长期相关性，但在日本，移动远程医疗应用程序的可及性存在区域相关性，尤其是在普通诊所。我们还发现疫情地区的移动远程医疗应用程序可及性更高。有必要对新冠疫情大流行之后远程医疗的实际使用情况及其效果进行进一步研究。
