The Patient Will Text You Now: Telemedicine and In-person Hospital Visits in China

Telemedicine improves access to healthcare by allowing remote access to high-quality services and increasing the labour supply of public hospital doctors. Additional benefits include improved hospital efficiency and quality of care through optimized patient flows, reduced duplicative efforts, and improved continuity of care. The COVID-19 pandemic also highlighted the critical role of telemedicine. However, there is limited evidence for the complementary effect of telemedicine on traditional healthcare, not to mention the influence of the COVID-19 pandemic. Little research has examined the effectiveness of telemedicine services on in-person healthcare utilization because of data limitations. China has enjoyed a vibrant online healthcare ecosystem and seen a significant uptake of telemedicine practice for hospitals and doctors. This paper uses two unique data sets – online service data and hospital visits data, to identify the impact of telemedicine utilization on hospital visits. Online service data, scraped online, contain extensive information on active doctors providing online health services through commercial third-party platforms. Hospital visits data has utilized aggregated population flow to hospitals at the city level, generated from mobile phone signaling data from one of China’s major mobile phone service providers. An event study regression model is used to examine the effect of COVID-19 pandemic on the provision of telemedicine services as well as hospital visits. Our results will provide significant empirical evidence on the effectiveness of telemedicine services and provide policy implications for the new healthcare paradigms for China and other developing countries.