JMIR Publications

ABSTRACT

Background:

Internet hospitals and Internet + nursing service have recently emerged as new medical and nursing care models, respectively. Both use Internet-based information platforms and combine online applications and offline services to provide appropriate services. The rapid growth in the number of Internet hospitals in China has given rise to the Internet hospital plus home nursing service model. Research on this new model is limited, and the effectiveness of its implementation remains to be clarified.

Objective:

We sought to examine the effectiveness of Internet hospital plus home nursing model implementation by investigating workload volume, patients’ satisfaction, and nurses’ perceptions to provide a strategic reference for Internet hospital plus home nursing development.

Methods:

Data of patients who applied for Internet hospital plus home nursing were collected from a hospital database. We analyzed the frequency of patients’ applications and the timeliness of Internet hospital plus home nursing using chi-squared tests. We used a frequency table to assess the classification of patients’ illnesses, service items, and geographic distribution. An image visualization method was used to display patients’ regional distribution. Finally, we compared the cost of transferring patients to hospital for nursing services with the cost of Internet hospital plus home nursing using a simulation technique, Mann-Whitney U test and explore associations between characteristic factors and costs using multiple linear regression. Patients’ satisfaction at different stages was compared using a U-test. Nurses’ attitudes and suggestions regarding The Internet hospital plus home nursing was examined with a questionnaire survey.

Results:

Medical records from 2459 Internet hospital plus home nursing patients were examined. Most Internet hospital plus home nursing patients were over 60 years old (2120/2459, 86.2%). The number of Internet hospital plus home nursing applications differed significantly between age groups (24=29.86, P<.001). Oncological patients were the most common type of Internet hospital plus home nursing users (1468/7415, 19.8%). Intravenous blood collection was the most common service item (4899/7415, 66.1%). Internet hospital plus home nursing patients were mainly from six regions around the physical hospital (2119/2459, 86.2%). All patients were served within 2 days after their appointment. The waiting time length varied significantly with appointment time (21=290.88, P<.001). U test revealed significant differences in cost distributions across gender, age, service frequency, service distance, and service type (all P<.001), including long-distance services (P=.007). Multivariate regression confirmed that service type and distance were key determinants of cost differences (P<.001). Patient satisfaction was very high in two time periods, with no significant difference (Mann-Whitney U=5,090,149.00, P=.380). Nurses' perceptions were positive.

Conclusions:

The Internet hospital plus home nursing model integrates online diagnosis and treatment with home care, thus forming a closed-loop service system that effectively improves medical accessibility for elderly patients and those with mobility impairments. The pilot program in Tianjin has demonstrated its significant advantages in terms of convenience, accessibility, and cost-effectiveness and has achieved high levels of patient satisfaction and nurse approval. Given this context, in an aging population, this model holds substantial potential for widespread adoption. Its sustainable development requires enhancement of safety mechanisms and policy support. As a comprehensive healthcare solution with distinct Chinese characteristics, it offers considerable reference value particularly for the global digital health sector.