Tran Joshua, Hao Ziyu, Xie Zongting, Yiu Karen, Li Adele, Tsoi Kelvin
The Chinese University of Hong Kong, Hong Kong, Hong Kong.
Cener Enviza, Shanghai, Shanghai, China.
BMJ Public Health. 2025 Jul 21;3(2):e002296. doi: 10.1136/bmjph-2024-002296. eCollection 2025.
The pandemic of COVID-19 accelerated the implementation of telemedicine and promoted the use of online consultations. This study aims to investigate the nationwide trends of online consultations over 10 years in China.
This is a sequential cross-sectional study to evaluate the usage of online consultations among clinicians from different specialities between 2014 and 2023. Stratified random sampling was applied to invite participants according to the geographical distribution of registered clinicians. The basic demographic information on gender, age, career levels, the specialities of practice, hospital levels across the region and city, and time spent on work-related online activities was collected. The average time spent on online consultations per week was the main outcome. Univariate and multivariable analyses were conducted to compare the profile differences of using mobile health applications.
A total of 65 305 clinicians from 39 clinical specialities in 31 provinces of China were interviewed anonymously through online surveys. On average, clinicians spent 36·5 hours per week on online activities in 2023 which increased from 20·7 hours per week in 2014. Time spent on online consultations has increased over the past 10 years from 1·1 to 2·9 hours with an average annual growth rate of 26%. Primary care and paediatric clinicians were the top-ranked in 2023. A general trend of increased time spent on online consultations can be observed with a particular spike during COVID-19. Mobile health has become popular for online consultations on portable devices. WeChat is the most common platform used (81·5%). In the multivariable analysis, clinicians with younger ages, senior career levels or from the department of surgery were more likely to use traditional websites for online consultation, but the interaction effect was observed between age and career levels.
Online consultations have become popular across different clinical disciplines in China over the past 10 years. There is a good acceptance of using mobile health for online consultations, and it may further enhance the accessibility of healthcare services, especially for patients who live in rural areas. Corresponding guidelines should be established to regulate the quality of online consultations for the future development of virtual healthcare.
新型冠状病毒肺炎大流行加速了远程医疗的实施，并促进了在线咨询的使用。本研究旨在调查中国10年来在线咨询的全国趋势。
这是一项序贯横断面研究，旨在评估2014年至2023年间不同专业临床医生在线咨询的使用情况。根据注册临床医生的地理分布，采用分层随机抽样邀请参与者。收集了关于性别、年龄、职业水平、执业专业、地区和城市的医院级别以及与工作相关的在线活动所花费时间的基本人口统计学信息。每周在线咨询的平均花费时间是主要结果。进行单变量和多变量分析以比较使用移动健康应用程序的特征差异。
通过在线调查对中国31个省份39个临床专业的65305名临床医生进行了匿名访谈。2023年临床医生平均每周花在在线活动上的时间为36.5小时，高于2014年的每周20.7小时。在过去10年中，在线咨询的花费时间从1.1小时增加到2.9小时，年平均增长率为26%。基层医疗和儿科临床医生在该领域的排名在2023年位居榜首。可以观察到在线咨询花费时间增加的总体趋势，在新型冠状病毒肺炎期间出现了特别的峰值。移动健康在便携式设备上的在线咨询中变得很流行。微信是最常用的平台（81.5%）。在多变量分析中，年龄较小、职业水平较高或来自外科的临床医生更有可能使用传统网站进行在线咨询，但年龄和职业水平之间存在交互作用。
在过去10年中，在线咨询在中国不同临床学科中变得很流行。使用移动健康进行在线咨询得到了很好的接受，并且它可能进一步提高医疗服务的可及性，特别是对于居住在农村地区的患者。应制定相应指南以规范在线咨询的质量，促进虚拟医疗的未来发展。
