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 + home nursing (IHHN) 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 IHHN model implementation by investigating service workload, patients’ satisfaction, and nurses’ perception to provide a strategic reference for IHHN development.

Methods:

Data from patients who received for IHHN were collected from a hospital database. We analyzed the frequency of patients’ applications and the timeliness of IHHN using descriptive statistics and Chi-squared tests. We used a frequency table to assess the classification of patients’ illnesses, service items, and geographic distribution. Geographical distribution of patients was visualized using spatial mapping techniques. Finally, we compared the cost of transferring patients to hospital by ambulance for nursing services with that of IHHN using a simulation technique and t-test. Patients’ satisfaction at two time periods was compared using a Mann-Whitney U-test. Nurses’ perceptions regarding IHHN were examined using a questionnaire survey.

Results:

Medical records from 2,459 IHHN patients were examined. Most IHHN patients were over 60 years old (86.21%). The number of IHHN applications differed significantly between age groups (2 = 29.86, P < 0.01). Oncological patients were the most common type of IHHN users (19.80%). Intravenous blood collection was the most common service item (66.07%). IHHN patients were mainly from six regions around the physical hospital (86.17%). All patients were served within 2 days after their appointment. The waiting time length varied significantly with appointment time (2 = 290.88, P < 0.01). The cost of routine and specialized service of IHHN was lower than the cost of transporting patients by ambulance to hospital (t = 53.63, P < 0.001, t = 22.98, P < 0.001). However, there was no significant difference between the costs of IHHN long distance services and transferring patients to hospital (t = 3.08, P = 0.77). Patient satisfaction was consistently high in two time periods, with no significant difference (Mann-Whitney U= 5090149.00, P = 0.38). Nurses’ perceptions were positive.

Conclusions:

IHHN demonstrates as an effective approach for providing convenient, accessible, and economical home nursing, addressing the shortcomings of online medical and nursing services such as difficulties in accessing medical care for the elderly and mobility-impaired patients. IHHN has high patient satisfaction degree and nurse positive perceptions As population aging progresses, IHHN services may expand. However, it is necessary to optimize services to ensure the safety of patients and nurses, and to provide corresponding policy support.