Social Media Landscape of the Tertiary Referral Hospitals in China: Observational Descriptive Study

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Abstract

Background

Social media has penetrated all walks of life. Chinese health care institutions are increasingly utilizing social media to connect with their patients for better health service delivery. Current research has focused heavily on the use of social media in developed countries, with few studies exploring its usage in the context of developing countries, such as China. Tertiary hospitals in China are usually located in city centers, and they serve as medical hubs for multiple regions, with comprehensive and specialized medical care being provided. These hospitals are assumed to be the pioneers in creating official social media accounts to connect with their patients due to the fact that they appear to have more resources to support this innovative approach to communication and health care education.

Objective

The objective of our study was to examine China’s best tertiary hospitals, as recognized by The National Health Commission of the People’s Republic of China (NHCPRC), and to map out the landscape of current social media usage by hospitals when engaging with patients.

Methods

We examined the best 705 tertiary hospitals in China by collecting and analyzing data regarding their usage of popular Chinese social media apps Sina Weibo and WeChat. The specific data included (1) hospital characteristics (ie, time since established, number of beds, hospital type, and regions or localities) and (2) status of social media usage regarding two of the most popular local social media platforms in China (ie, time of initiation, number of followers, and number of tweets or posts). We further used a logistic regression model to test the association between hospital characteristics and social media adoption.

Results

Of all, 76.2% (537/705) tertiary referral hospitals have created official accounts on either Sina Weibo or WeChat, with the latter being more popular among the two. In addition, our study suggests that larger and newer hospitals with greater resources are more likely to adopt social media, while hospital type and affiliation with universities are not significant predictors of social media adoption among hospitals.

Conclusions

Our study demonstrated that hospitals are more inclined to use WeChat. The move by hospitals from Sina Weibo to WeChat indicates that patients are not satisfied by mere communication and that they now place more value on health service delivery. Meanwhile, utilizing social media requires comprehensive thinking from the hospital side. Once adopted, hospitals are encouraged to implement specific rules regarding social media usage. In the future, a long journey still lies ahead for hospitals in terms of operating their official social media accounts.

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Adoption and use of social media among public health departments

Rosemary Thackeray, Brad Neiger, Amanda Smith … (2012)

Background Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applications are used most often; and 3) how often social media is used interactively to engage audiences. Methods This was a non-experimental, cross sectional study of SHD social media sites. Screen capture software Snag-It® was used to obtain screenshots of SHD social media sites across five applications. These sites were coded for social media presence, interactivity, reach, and topic. Results Sixty percent of SHDs reported using at least one social media application. Of these, 86.7% had a Twitter account, 56% a Facebook account, and 43% a YouTube channel. There was a statistically significant difference between average population density and use of social media (p = .01). On average, SHDs made one post per day on social media sites, and this was primarily to distribute information; there was very little interaction with audiences. SHDs have few followers or friends on their social media sites. The most common topics for posts and tweets related to staying healthy and diseases and conditions. Limitations include the absence of a standard by which social media metrics measure presence, reach, or interactivity; SHDs were only included if they had an institutionally maintained account; and the study was cross sectional. Conclusions Social media use by public health agencies is in the early adoption stage. However, the reach of social media is limited. SHDs are using social media as a channel to distribute information rather than capitalizing on the interactivity available to create conversations and engage with the audience. If public health agencies are to effectively use social media then they must develop a strategic communication plan that incorporates best practices for expanding reach and fostering interactivity and engagement.

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Inequality in the distribution of health resources and health services in China: hospitals versus primary care institutions

Tao Zhang, Yongjian Xu, Jianping Ren … (2017)

Background Equity is one of the major goals of China’s recent health system reform. This study aimed to evaluate the equality of the distribution of health resources and health services between hospitals and primary care institutions. Methods Data of this study were drawn from the China Health Statistical Year Books. We calculated Gini coefficients based on population size and geographic size, respectively, for the indicators: number of institutions, number of health workers and number of beds; and the concentration index (CI) for the indicators: per capita outpatient visits and annual hospitalization rates. Results The Gini coefficients against population size ranged between 0.17 and 0.44 in the hospital sector, indicating a relatively good equality. The primary care sector showed a slightly higher level of Gini coefficients (around 0.45) in the number of health workers. However, inequality was evident in the geographic distribution of health resources. The Gini coefficients exceeded 0.7 in the geographic distribution of institutions, health workers and beds in both the hospital and the primary care sectors, indicating high levels of inequality. The CI values of hospital inpatient care and outpatient visits to primary care institutions were small (ranging from -0.02 to 0.02), indicating good wealth-related equality. The CI values of outpatient visits to hospitals ranged from 0.16 to 0.21, indicating a concentration of services towards the richer populations. By contrast, the CI values of inpatient care in primary care institutions ranged from -0.24 to -0.22, indicating a concentration of services towards the poorer populations. The eastern developed region also had a high internal inequality compared with the other less developed regions. Conclusion Significant inequality in the geographic distribution of health resources is evident, despite a more equitable per capita distribution of resources. Richer people are more likely to use well-resourced hospitals for outpatient care. By contrast, poorer people are more likely to use poorly-resourced primary care institutions for inpatient care. There is a risk of the emergence of a two-tiered health care delivery system.

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Diffusion of Innovations.

E. ROGERS, Rogers Everett, E Rogers … (1995)

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Author and article information

Contributors

Zhaohua Deng:

Institute of Smart HealthSchool of Medicine and Health ManagementHuazhong University of Science and TechnologyNo. 13 Hangkong Road, Qiaokou DistrictWuhan, 430030China86 15926318828zh-deng@hust.edu.cn

ORCID: http://orcid.org/0000-0002-7744-7818

Journal

Journal ID (nlm-ta): J Med Internet Res

Journal ID (iso-abbrev): J. Med. Internet Res

Journal ID (publisher-id): JMIR

Title: Journal of Medical Internet Research

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Print): 1439-4456

ISSN (Electronic): 1438-8871

Publication date Collection: August 2018

Publication date (Electronic): 09 August 2018

Volume: 20

Issue: 8

Electronic Location Identifier: e249

Affiliations

[1] ¹ Institute of Smart Health School of Medicine and Health Management Huazhong University of Science and Technology Wuhan China

[2] ² Business Information Management and Operations University of Westminster London United Kingdom

[3] ³ Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China

[4] ⁴ School of Journalism and Communication Chongqing University Chongqing China

Author notes

Corresponding Author: Zhaohua Deng zh-deng@ 123456hust.edu.cn

Author information

Wei Zhang http://orcid.org/0000-0003-0178-0750

Zhaohua Deng http://orcid.org/0000-0002-7744-7818

Richard Evans http://orcid.org/0000-0001-6367-0560

Fei Xiang http://orcid.org/0000-0002-9783-9253

Qing Ye http://orcid.org/0000-0002-5432-7741

Runxi Zeng http://orcid.org/0000-0002-8353-9479

Article

Publisher ID: v20i8e249

DOI: 10.2196/jmir.9607

PMC ID: 6107732

PubMed ID: 30093370

SO-VID: 483a968c-b223-48d9-a0f3-10b368257f42

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/.as well as this copyright and license information must be included.

History

Date received : 8 December 2017

Date revision requested : 18 March 2018

Date revision received : 26 May 2018

Date accepted : 18 June 2018

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