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Research article - Peer-reviewed, 2020

Tripartite Data Analysis for Optimizing Telemedicine Operations: Evidence from Guizhou Province in China

Yu, Jinna; Zhang, Tingting; Liu, Zhen; Abouhatab, Assem; Lan, Jing


Telemedicine is an innovative approach that helps alleviate the health disparity in developing countries and improve health service accessibility, affordability, and quality. Few studies have focused on the social and organizational issues involved in telemedicine, despite in-depth studies of and significant improvements in these technologies. This paper used evolutionary game theory to analyze behavioral strategies and their dynamic evolution in the implementation and operation of telemedicine. Further, numerical simulation was carried out to develop management strategies for promoting telemedicine as a new way of delivering health services. The results showed that: (1) When the benefits are greater than the costs, the higher medical institutions (HMIs), primary medical institutions (PMIs), and patients positively promote telemedicine with benign interactions; (2) when the costs are greater than the benefits, the stability strategy of HMIs, PMIs, and patients is, respectively, 'no efforts', 'no efforts', and 'non-acceptance'; and (3) promotion of telemedicine is influenced by the initial probability of the 'HMI efforts', 'PMI efforts', and 'patients' acceptance' strategy chosen by the three stakeholders, telemedicine costs, and the reimbursement ratio of such costs. Based on theoretical analysis, in order to verify the theoretical model, this paper introduces the case study of a telemedicine system integrated with health resources at provincial, municipal, county, and township level in Guizhou. The findings of the case study were consistent with the theoretical analysis. Therefore, the central Chinese government and local governments should pay attention to the running cost of MIs and provide financial support when the costs are greater than the benefits. At the same time, the government should raise awareness of telemedicine and increase participation by all three stakeholders. Lastly, in order to promote telemedicine effectively, it is recommended that telemedicine services are incorporated within the scope of medical insurance and the optimal reimbursement ratio is used.


telemedicine; tripartite data analysis; optimizing telemedicine operations

Published in

International journal of environmental research and public health
2020, volume: 17, number: 1, article number: 375

Authors' information

Yu, Jinna
Guizhou Minzu University
Zhang, Tingting
University of Science and Technology Beijing
Liu, Zhen
Nanjing Normal University
Swedish University of Agricultural Sciences, Department of Economics
Arish University
Lan, Jing
Nanjing Agricultural University

Sustainable Development Goals

SDG3 Good health and well-being
SDG9 Industry, innovation and infrastructure
SDG17 Partnerships for the goals

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