JMIR Publications

ABSTRACT

Background:

Along with the spread of novel coronavirus disease (COVID-19), internet hospitals in China were engaged in the epidemic prevention and control, offering epidemic-related online services and medical supports to the public.

Objective:

To explore the role of internet hospitals during the prevention and control of COVID-19 in China.

Methods:

Online epidemic-related consultations from multicenter internet hospitals in China during the epidemic of COVID-19 were collected. The counselees were described and classified into seven type groups. Symptoms were recorded and compared with reported COVID-19 patients. Hypochondriacal suspicion and offline-visit motivation were detected within each counselees’ group to evaluate the social panic of the epidemic along with the consequent medical seeking behaviors. The counselees’ motivation and the doctors’ recommendation for offline visit were compared. Risk factors affecting the counselees’ tendency of hypochondriacal suspicion and offline visit were explored by logistic regression models. The epidemic prevention and control measures based on internet hospitals were listed and the corresponding effects were discussed.

Results:

4913 consultations were enrolled for analysis with the median age of the counselees 28 years (inter-quartile range: 22-33 years). There were 104(2.1%) healthy counselees, 147(3.0%) hypochondriacal counselees, 34(0.7%) exposed counselees, 853(17.4%) mildly suspicious counselees, 42(0.9%) moderately suspicious counselees, 3550(72.3%) highly suspicious counselees and 183(3.7%) severely suspicious counselees. 94.2% counselees had epidemic-related symptoms with a distribution similar to those of COVID-19. The hypochondriacal suspicion mode (44.1%) was common. The counselees’ motivation and the doctors’ recommendation for offline visit were inconsistent (P<0.001) with Cohen Kappa score 0.039, indicating irrational medical-seeking behaviors. Adult counselees (OR=1.816, P<0.001) with epidemiological exposure (OR= 7.568, P<0.001), shortness of breath (OR=1.440, P=0.001), diarrhea (OR=1.272, P=0.04) and unrelated symptoms (OR=1.509, P<0.001) were more likely to have hypochondriacal suspicion. Counselees with severe illnesses (OR= 2.303, P<0.001), fever (OR= 1.660, P<0.001), epidemiological exposure history (OR=1.440, P=0.012) and hypochondriacal suspicion (OR= 4.826, P<0.001) were more likely to attempt for offline visit. Re-attended counselees (OR=0.545, P=0.002) were less motivated to go to the offline clinic.

Conclusions:

Internet hospitals can serve different types of epidemic counselees, offer essential medical supports to the public during COVID-19, further release the social panic, promote social distancing, enhance the public’s ability of self-protection, correct irrational medical seeking behaviors, reduce the chance of nosocomial cross infection, facilitate epidemiological screening, thus play an important role on preventing and controlling COVID-19.