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. 2024 Mar 12;39(3):307-317.
doi: 10.1093/heapol/czad119.

The quality of telemedicine consultations for sexually transmitted infections in China

Yafei Si  1   2   3   4 , Hao Xue  5 , Huipeng Liao  4 , Yewei Xie  4   6 , Dong Roman Xu  7   8 , M Kumi Smith  9 , Winnie Yip  10 , Weibin Cheng  11   12 , Junzhang Tian  11 , Weiming Tang  4   11   13 , Sean Sylvia  14   15   16
Affiliations

The quality of telemedicine consultations for sexually transmitted infections in China

Yafei Si et al. Health Policy Plan. .

Abstract

The burden of sexually transmitted infections (STIs) continues to increase in developing countries like China, but the access to STI care is often limited. The emergence of direct-to-consumer (DTC) telemedicine offers unique opportunities for patients to directly access health services when needed. However, the quality of STI care provided by telemedicine platforms remains unknown. After systemically identifying the universe of DTC telemedicine platforms providing on-demand consultations in China in 2019, we evaluated their quality using the method of unannounced standardized patients (SPs). SPs presented routine cases of syphilis and herpes. Of the 110 SP visits conducted, physicians made a correct diagnosis in 44.5% (95% CI: 35.1% to 54.0%) of SP visits, and correctly managed 10.9% (95% CI: 5.0% to 16.8%). Low rates of correct management were primarily attributable to the failure of physicians to refer patients for STI testing. Controlling for other factors, videoconference (vs SMS-based) consultation mode and the availability of public physician ratings were associated with higher-quality care. Our findings suggest a need for further research on the causal determinants of care quality on DTC telemedicine platforms and effective policy approaches to promote their potential to expand access to STI care in developing countries while limiting potential unintended consequences for patients.

Keywords: Quality of care; direct-to-consumer telemedicine; sexually transmitted infections; standardized patient.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1.
Figure 1.
The distribution of each specific item in the checklist
Figure 2.
Figure 2.
The quality of STIs care by delivery model
Figure 3.
Figure 3.
Decision tree of disease management
Figure 4.
Figure 4.
Correlates of diagnostic skills and disease management
See this image and copyright information in PMC

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