Abstract
OBJECTIVE: Telemedicine is expected to be useful in rural areas owing to its advantages in improving patient access to medical care. In Japan, rural clinics and core hospitals are assigned to provide rural medical care according to the medical plans formulated for each prefecture. However, the relationship between telemedicine use in such medical facilities and the role of local governments remains unclear. Therefore, their relationship was investigated in this study. MATERIALS AND METHODS: A nationwide survey was conducted in 2022. Questionnaires were sent to rural clinics (n=1,006) and core hospitals (n=334) via mail. RESULTS: The response rates for rural clinics and core hospitals were 51.2% and 50.6%, respectively. Telemedicine was used in 24.9% of the clinics and 24.9% of the core hospitals. Local government collaboration was significantly more prevalent in the telemedicine (+) group than in the telemedicine (-) group in rural clinics (44.5% vs. 5.2%, P<0.01) and core hospitals (35.7% vs. 19.4%, P<0.05). In the telemedicine (-) group, the first-ranked barrier to telemedicine use was hardware preparation (clinics, 34.0%; core hospitals, 26.4%), followed by financial issues (clinics, 22.4%; core hospitals, 22.0%). In the telemedicine (+) group in rural clinics, both doctor-to-patient (45.6% vs. 22.5%, P<0.01) and doctor-to-patient with nurse models (52.6% vs. 7.0%, P<0.01) were significantly more prevalent in collaboration with local governments. CONCLUSION: The relationship between rural medical care facilities and local government collaborations may contribute to the development of rural telemedicine in Japan.