Huang Zhongmou, Wan Xizi, Zhou Shaojie, Yu Miao
School of Public Policy and Management Tsinghua University Beijing China.
Shenzhen International Graduate School Tsinghua University Beijing China.
Health Care Sci. 2025 May 29;4(3):215-224. doi: 10.1002/hcs2.70017. eCollection 2025 Jun.
The scarcity of healthcare resources and inadequate access to medical services in rural and remote areas are pervasive challenges many countries face, particularly in the developing world. Telemedicine, with its capacity to overcome geographical barriers and provide patients with real-time medical services, has shown considerable potential in addressing these issues, attracting widespread attention. Compact medical communities and family doctor systems play important roles in improving healthcare accessibility. However, despite the critical nature of patients' perceptions of healthcare accessibility, research in this domain is sparse. This study aimed to explore the impact of telemedicine on rural residents' perceived healthcare accessibility in China, analyze the mechanisms underpinning this relationship, and elucidate the roles of compact medical communities and the family doctor system.
Survey data from 3311 rural residents were analyzed using a probit model, instrumental variables, and subgroup regression analyses to ascertain causal effects, perform heterogeneity analysis, examine mechanisms, and ascertain the robustness of the findings.
Telemedicine significantly enhanced rural residents' perceived healthcare accessibility, with particularly notable benefits for those in sparsely populated areas, regions with high-speed internet access, within the purview of compact healthcare consortiums, and those with access to family doctor services. Furthermore, telemedicine improved rural residents' perceived healthcare accessibility by encouraging the use of primary care services.
Telemedicine in China has played a significant role in improving the perceived healthcare accessibility among rural residents and aiding in the reduction of disparities in accessibility across different demographic groups. This is consistent with the broader objective of achieving universal health coverage. However, the efficacy of telemedicine in enhancing healthcare accessibility is contingent upon certain preconditions. Policymakers must confront local infrastructure challenges, particularly regarding internet connectivity, when expanding telemedicine services to ensure their effective operation. The synergistic interaction observed between telemedicine, the family doctor system, and compact medical communities highlights the importance of integrating telemedicine into existing healthcare systems. Such integration could enhance collaboration with current healthcare frameworks, ensuring the provision of safe, accessible, and affordable healthcare services, and promoting the health and well-being of local populations.
医疗资源匮乏以及农村和偏远地区医疗服务可及性不足是许多国家面临的普遍挑战，在发展中国家尤为如此。远程医疗能够克服地理障碍并为患者提供实时医疗服务，在解决这些问题方面显示出巨大潜力，受到广泛关注。紧密型医疗共同体和家庭医生制度在提高医疗可及性方面发挥着重要作用。然而，尽管患者对医疗可及性的认知至关重要，但该领域的研究却很稀少。本研究旨在探讨远程医疗对中国农村居民感知医疗可及性的影响，分析这种关系背后的机制，并阐明紧密型医疗共同体和家庭医生制度的作用。
使用概率模型、工具变量和亚组回归分析对3311名农村居民的调查数据进行分析，以确定因果效应、进行异质性分析、检验机制并确定研究结果的稳健性。
远程医疗显著提高了农村居民感知的医疗可及性，对人口稀少地区、高速互联网接入地区、紧密型医疗联合体范围内以及能够获得家庭医生服务的居民的益处尤为显著。此外，远程医疗通过鼓励使用基层医疗服务提高了农村居民感知的医疗可及性。
中国的远程医疗在提高农村居民感知的医疗可及性以及帮助减少不同人口群体之间的可及性差距方面发挥了重要作用。这与实现全民健康覆盖的更广泛目标相一致。然而，远程医疗在提高医疗可及性方面的效果取决于某些前提条件。政策制定者在扩大远程医疗服务时必须应对当地的基础设施挑战，特别是互联网连接方面的挑战，以确保其有效运行。远程医疗、家庭医生制度和紧密型医疗共同体之间观察到的协同互动凸显了将远程医疗纳入现有医疗体系的重要性。这种整合可以加强与当前医疗框架的协作，确保提供安全、可及且负担得起的医疗服务，并促进当地居民的健康和福祉。
