HAS COVID-19 INTENSIFIED VISITING BEHAVIORS OF ONLYFANS AND ITS ALTERNATIVES?: AN EMPIRICAL ANALYSIS

Due to multiple COVID-19 lockdowns, individuals likely engaged in multiple activities, including viewing adult content. Even though a subscription-based pornographic content sharing (SPCS) website (e.g., OnlyFans or Fancentro) is operationally distinct from traditional sexual channels (e.g., Pornhub or Xvideos), no study has examined whether COVID-19 increased the visiting behaviors of these SPCS websites. Consequently, we attempted to address this void. The subscription to comScore services by Chulalongkorn Business School allowed us to utilize actual visitor behavior at three SPCS websites before and during COVID-19. The analysis of 17,477 visit sessions revealed that (1) pageviews and visit duration peaked before the pandemic, but (2) the average length of stay per pageview increased during the pandemic compared to before its introduction. In addition to providing theoretical insight into the relationship between COVID-19 and website-visiting behaviors of SPCS, our findings offer practical contributions. © 2023, International Journal of Economics and Finance Studies. All Rights Reserved.

The Role of Information Sources on Tourist Behavior Post-Earthquake Disaster in Indonesia: A Stimulus–Organism–Response (SOR) Approach

The earthquake disaster has an impact on tourist visit intention. This study aims to investigate tourist behavior in the post-earthquake disaster linkage between information sources (word of mouth and electronic word of mouth) and risk perception toward tourists' visit intentions to a destination in Indonesia. This study applies the SOR theory to predict tourists' behavior in the destination aftermath. The Partial Least Squares Structural Equation Model was used to examine the hypothesis of the study. The result found that information sources (electronic word of mouth and word of mouth) significantly influenced visit intention in the time of post-earthquake disaster. The risk perception has not significantly influenced visit intention in post-earthquake disasters. The discussion and conclusion of the study are discussed herein. Overall, the findings of the study may contribute to the theory by adding information sources to predict tourist behavior post-earthquake disaster and also gives a practical contribution to the tourism sector, stakeholders, tourism marketers, and policymakers in Indonesia to enhance the marketing strategy by considering destination promotion through word of mouth (offline) and electronic word of mouth (online) and its mechanism on tourists' travel decision in the time of aftermath.

Did virtual consultations during Covid-19 improve diabetes transition clinic attendance compared to face to face clinic attendance

We have an established transition clinic for the patients with diabetes aged 16 to 19. Our Transition clinic covers a vast area including deprived areas such as Ellesmereport. We do have 3 monthly follow up in addition to the home visits by paedatric diabetes specialist nurses. The team involves paediatric consultants, pdsn and dietcician from adult and paedatrics departments. Virtual consultation were the main mode of consultations during covid. We used Accu Rx, Attendanywhere and telephone consultations. We compared the clinic attendance pre and post covid. We compared clinic attendance for 9 months from March 2019 to December 2019 which were pre Covid to March 2020 to December 2020 during Covid. We had 150 appointments in 2019 and 112 appointments in 2020. The DNAs were 21 during covid with virtual consultations and 28 pre Covid with face to face appointments. The DNA rates were 18.6% in 2019 as face to face review and 18.75% during covid as virtual consultations. Surprisingly, the DNA rates did not improve when the clinics were virtual as we expected. In Conclusion, the virtual consultations did not improve the attendance in this vulnerable age group. Due to vulnerability of this age group, we felt that the face to face consultations were more appropriate. All of our appointments for the diabetes transition clinics are face to face in person due to above findings.

Home-based care programme (HBCP) for patients with COVID-19: Boon or burden during pandemic management?

Introduction and Aim: India experienced the peak of the second wave of COVID-19 during April to June 2021. Massive surge of cases resulting in shortage of beds and oxygen, home care was recommended as a strategy for management of asymptomatic/mild COVID-19 cases. The present study was undertaken to perform home visits and monitor COVID 19 patients who are a part of home-based care programme (HBCP) in Puttur taluk of Dakshina Kannada district, identification and immediate referral of patients with red flag signs/ symptoms and to identify barriers/challenges faced by health care staff in implementing the programme. Methodology: The present study was a cross-sectional study with universal sampling. It was carried out as part of a district programme for management of home isolation COVID-19 patients. The team visited the houses of COVID-19 patients and evaluated them. Result(s): A total of 112 COVID-19 patients were in home isolation during the study period in Puttur Taluk. Hypertension (29.5%) was the most common co-morbidity and nearly two-fifths (41.1%) of the study participants had one or more comorbidities. Almost two-third (63%) of the patients with comorbidities were symptomatic compared to only 29.4% of patients without any comorbidities. Of the six patients who had saturation of less than 95% five were more than 60 years of age, only one had received vaccination against COVID-19 and all had comorbidities. The HBCP had to face several challenges as the team members could not be in full PPE because of long distances between the houses and hard to reach areas. Conclusion(s): Overall, it is a helpful initiative for patients as the health services were provided at the doorstep during the time of restriction of movement. This can be an important tool in managing not only COVID pandemic but also future outbreaks that may follow.Copyright © 2023, Indian Association of Biomedical Scientists. All rights reserved.

Implementation and recommendation of postpartum visit methods during COVID-19 pandemic: a qualitative study from Indonesia

Background. The Maternal Mortality Rate (MMR) in Indonesia is still a health problem that must be solved. In 2018 and 2019, the postpartum period still dominates maternal mortality in Surabaya. The postpartum visit method is one of the essential things that can affect postpartum services, so it is necessary to evaluate the implementation of the postpartum visit method and recommend visiting methods to improve maternal health. Objective.The study explores the implementation and recommendation of postpartum visit methods during the COVID-19 Pandemic. Materials and Methods. It used a qualitative research type by assessing the interview and observation dept. The instruments used are questionnaires and observation sheets. Researchers conducted interviews with 14 mothers who had completed the postpartum period, five midwives, a stakeholder in the health office and two experts in the field of maternal health. The data is processed using organizing, reduction, coding, description, linking between themes, and data interpretation. Results. Offline visits to health facilities still dominate the implementation of the postpartum visit method. The recommended postpartum visit method combines visits to health facilities, home visits, and telehealth. Besides that, it is necessary to consider maternal postpartum services up to 3 months after delivery, especially for postpartum mothers who have problems. Conclusion. The postpartum visit method during the COVID-19 pandemic, has not run optimally because there are restrictions on offline visits. However, it has not been supported by online monitoring or home visits.Copyright © the Author(s), 2023.

Disruptions to in-person medical visits across the United States during the COVID-19 pandemic: evolving disparities by medical specialty and socio-economic status.

OBJECTIVES: This study aimed to investigate how people's health-seeking behaviors evolve in the COVID-19 pandemic by community and medical service category. STUDY DESIGN: This is a longitudinal study using mobility data from 19 million mobile devices of visits to all types of health facility locations for all US states. METHODS: We examine the variations in weekly in-person medical visits across county, neighborhood, and specialty levels. Different regression models are used for each level to investigate factors that influence the disparities in medical visits. County-level analysis explores associations between county medical visit patterns, political orientation, and COVID-19 infection rate. Neighborhood-level analysis focuses on neighborhood socio-economic compositions as potential determinants of medical visit levels. Specialty-level analysis compares the evolution of visit disruptions in different specialties. RESULTS: A more left-leaning political orientation and a higher local infection rate were associated with larger decreases in in-person medical visits, and these associations became stronger, moving from the initial period of stay-at-home orders into the post-lockdown period. Initial reactions were strongest for seniors and those of high socio-economic status, but this reversed in post-lockdown period where socio-economically disadvantaged communities stabilized at a lower level of medical visits. Neighborhoods with more female and young people exhibited larger decreases in in-person medical visits throughout the initial and post-lockdown periods. The evolution of disruptions diverges across medical specialties, from only short-term disruption in specialties such as dentistry to increasing disruption, as in cardiology. CONCLUSIONS: Given distinct patterns in visit between communities, medical service categories, and between different periods in the pandemic, policy makers, and providers should concentrate on monitoring patients in disrupted specialties who overlap with the at-risk contexts and socio-economic factors in future health emergencies.

Disrupted Routine Medical Visits in Children and Adolescents During the COVID-19 Pandemic, January-June 2021.

Introduction: Recent studies have indicated the coronavirus disease 2019 (COVID-19) pandemic has disrupted routine vaccinations. This study describes the prevalence and characteristics of children and adolescents experiencing disrupted routine vaccination and other medical visits in the United States between January and June 2021. Methods: The National Immunization Surveys were the source of data for this cross-sectional analysis (n= 86,893). Parents/guardians of children aged 6 months through 17 years were identified through random digit dialing of cellular phone numbers and interviewed. Disrupted visits were assessed by asking, "In the last two months, was a medical check-up, well child visit, or vaccination appointment for the child delayed, missed, or not scheduled for any reason?" Respondents answering yes were asked "Was it because of COVID-19?" Sociodemographic characteristics of children/adolescents with (1) COVID-19-related missed visits and (2) non-COVID-19-related missed visits were examined. Statistical differences within demographic subgroups were determined using t-tests, with p<0.05 considered statistically significant. Linear regression models were used to examine trends in disrupted visits over time. Results: An estimated 7.9% of children/adolescents had a missed visit attributed to COVID-19; 5.2% had a missed visit that was not COVID-19-related. Among children/adolescents with a COVID-19-related missed visit, a higher percentage were of minority race or ethnicity, lived below the poverty level, had a mother without a college degree, and lived in the western United States. There was a significant decline in COVID-19-related missed visits over time. Conclusion: COVID-19 disrupted routine vaccination or other medical visits inequitably. Catch-up immunizations are essential for achieving adequate vaccination of all children/adolescents.

The Use of a Single-Time Sit-To-Stand Test in Ambulatory Individuals With Spinal Cord Injury by Primary Health Care Providers.

Background: The uncertain health care situations, such as that created by the COVID-19 pandemic, has limited hospital access and facilitated a paradigm shift in health care toward an increased demand for standard home visits and community-based rehabilitation services, including by ambulatory individuals with spinal cord injury (SCI). Objectives: This 6-month prospective study explored the validity and reliability of a single-time sit-to-stand (STSTS) test when used by primary health care (PHC) providers, including a village health volunteer, caregiver, individual with SCI, and health professional. Methods: Eighty-two participants were assessed for the STSTS using four arm placement conditions (arms on a walking device, arms on knees, arms free by the sides, and arms crossed over the chest) and standard measures, with prospective fall data follow-up over 6 months. Thirty participants involved in the reliability study were also assessed and reassessed for the ability to complete the STSTS conditions by PHC providers. Results: Outcomes of the STSTS test, except the condition with arms on a walking device, could significantly discriminate lower extremity muscle strength (LEMS) and mobility of the participants (rpb = -0.58 to 0.69) with moderate concurrent validity. Outcomes of the tests without using the arms also showed moderate to almost-perfect reliability (kappa = 0.754-1.000) when assessed by PHC raters. Conclusion: The findings suggest the use of an STSTS with arms free by the sides as a standard practical measure by PHC providers to reflect LEMS and mobility of ambulatory individuals with SCI in various clinical, community, and home-based settings.

Supporting family video visits during COVID-19: the experiences of the Community Restorative Centre

The Community Restorative Centre (CRC) is based in New South Wales, with its family worker and telephone information and referral service worker providing support to the families of people in prison in that state. The COVID-19 pandemic and resulting suspension of face-to-face visits to incarcerated loved ones caused a high level of distress to families, which was partially alleviated by the introduction of video visits directly to the family's own smart device. This new system of video visiting was not without difficulties but provided a welcome method of staying in contact with a loved one in custody. CRC staff were able to provide ongoing emotional support and accurate, up-to-date information to family members throughout the pandemic and alleviate some of the misinformation and resulting distress experienced by families who were concerned about the physical and emotional wellbeing of their relative in custody.

Re-Emergence of Measles

In 2018-19, even before the pandemic, the world experienced major outbreaks of measles with 140,000 reported deaths mostly in low income countries where children suffer from malnutrition and overcrowding. In areas recovering from natural disasters and conflict areas and most children remain unvaccinated, outbreaks occur. The Philippines suffered similarly, with a devastating outcome and deaths of more than 800 children, even adults, in more than 40,000 hospitalized cases reported in 2019 over a 2 month period. A massive loss of vaccine confidence in 2018, brought about by the controversial introduction of a dengue vaccine reduced childhood vaccination coverage at an all-time low of 40-50%. Previous rates were in the 80-90% and measles was almost on the verge of elimination with no deaths and no cases between 2005-2009. The basic elements of complacency, convenience and confidence plus frequent occurrence of natural disasters over the years contributed much to these measles outbreaks. As a strategy, the government went into a massive supplementary immunization program with measles campaign including home visits to prevent another outbreak in the next 2 years after the pandemic begun. It has been implemented but targets are still wanting. The lessons learned from Measles resurgence are echoing all throughout the world and as the global response to the COVID19 continues, the measles as well as polio and other vaccine- preventable diseases need to be addressed with strategies that each country would find appropriate for them. Without sustained attention, the gains that have been achieved previously could easily get lost.Copyright © 2023

Analysis of case-based malaria surveillance and response during the period of COVID-19 outbreak in China

Objective To assess the case-based malaria surveillance and response during the period of COVID-19 outbreak in China, in order to provide reference for malaria elimination under the COVID-19 pandemic. Methods Information of malaria cases reported during the four months pre - and post-COVID -19 outbreak (December 1, 2019-March 31, 2020) and in the same time period of past two years in China (excluding Hong Kong, Macau and Taiwan regions) was obtained from the Parasitic Disease Control Information Management System. Cross-sectional survey and comparison were conducted for malaria surveillance and response data in 3 four-month time periods (December 1, 2019 to January 22, 2020;January 23 to March 17, 2020;and March 18-31, 2020). The number of malaria cases including deaths, the median and average time interval from disease onset to the first visit, the median and average of time interval from the first visit to the confirmed diagnosis, the completion status of the #1-3-7$ task and the source of infections in each period were analyzed and compared to the same times in the past two years. Results From December 1, 2019 to March 31, 2020, a total of 750 malaria cases, which were all imported cases, were reported in China, decreased by 9.2% from that reported during December 2018 and March 2019 (826 cases) and by 13.1% from that reported during December 2017 to March 2018 (863 cases). The decrease mainly occurred in February and March in 2020;there were no statistical differences in the time interval from onset to first visit (median 1 day, mean 2.0 days), time interval from first visit to confirmed diagnosis (median 1 day, mean 1.8 days), case reporting rate within 1 day (100%), case epidemiological investigation rate within 3 days (98.4%), epidemic site disposal rate within 7 days (100%) between the time period of COVID-19 outbreak and the same time in the past year (December 2018 to March 2019). In addition, no statistical difference (! > 0.05) was found in the time intervals from onset to first visit among the first period [median 1 d, average (1.9 +/- 0.2) d], the second period [median 1 d, average (2.1 +/- 0.3) d] and the third period [median 1 d, mean (1.5 +/- 0.3) d], while the time interval from the first visit to the confirmed diagnosis was statistically different (! X 0.05) among the first period [median 0 d, average (1.5 +/- 0.2) d], the second period [median 1 d, mean (2.3 +/- 0.3) d] and the third period [median 0.5 d, average (1.5 +/- 0.4) d], where the time interval in the second period was longer than that in the first period (! X 0.01). Conclusion China' s core measures to eliminate malaria have been carried out as planned, although the timely malaria diagnosis was slightly affected in the second time period (January 23 to March 17, 2020).Copyright © 2021, National Institute of Parasitic Diseases. All rights reserved.

Exploration of patients' preference for modalities of care among peritoneal dialysis patients in Singapore: a single-center experience.

INTRODUCTION: Peritoneal dialysis (PD) is home-based dialysis therapy and therefore a suitable modality for kidney failure patients, particularly, during the COVID-19 pandemic. The present study examined patients' preferences for different PD-related services. METHODS: This was a cross-sectional survey study. Anonymized data from PD patients followed up at a single center in Singapore were collected using an online platform. The study focused on telehealth services, home visits, and monitoring of quality-of-life (QoL). RESULTS: A total of 78 PD patients responded to the survey. The majority of participants were Chinese (76%), married (73%), and between 45 and 65 years old (45%). The in-person visit was preferred over teleconsultation for consultation with nephrologists (68% versus 32%), counseling for kidney disease and dialysis by renal coordinators (59%), whereas the telehealth service was favored over in-person visit for dietary counseling (60%) and medication counseling (64%). Most participants (81%) preferred medication delivery over self-collection, and the acceptable turnaround time was 1 week. Sixty percent would like to have a regular home visit, but 23% refused such visits. The preferred frequency of home visits was one-to-three visits within the first 6 months (74%) and then 6 monthly for subsequent visits (40%). The majority of participants (87%) agreed with QoL monitoring, and the preferred frequency of monitoring varied between 6 monthly (45%) and yearly (40%). Participants also indicated three key areas in research to improve QoL, such as the development of artificial kidneys, portable PD devices, and simplification of PD procedure. Participants also would like to see improvement in two main areas of PD services, such as delivery service for PD solutions and social (instrumental, informational, and emotional) support. CONCLUSIONS: Most PD patients preferred in-person visits with nephrologists or renal coordinators; however, they favored telehealth services with dieticians and pharmacists. PD patients also welcomed home visit service and QoL monitoring. Future studies should confirm these findings.

Pilot Observational Study of Patient Reported Outcome Measures for Long COVID Patients in Virtual Integrative Medical Group Visits.

Background: Long COVID is a common, debilitating post-infectious illness for which effective management is unknown. Integrative Medical Group Visits (IMGV) are effective interventions for chronic conditions and could benefit Long COVID patients. More information is needed regarding existing patient reported outcome measures (PROMs) to evaluate efficacy of IMGV for Long COVID. Objective: This study assessed the feasibility of specific PROMS to evaluate IMGVs for Long COVID. Findings will inform future efficacy trials. Methods: The Perceived Stress Scale (PSS-10), General Anxiety Disorder two-question tool (GAD-2), Fibromyalgia Symptom Severity scale (SSS), and Measure Yourself Medical Outcome Profile (MYMOP®) were collected pre- and post-group by teleconferencing platform or telephone and compared using paired t-tests. Patients were recruited from a Long COVID specialty clinic where they participated in 2-hour - 8 weekly IMGV sessions online. Results: Twenty-seven participants enrolled and completed pre-group surveys. Fourteen participants were reachable by phone post-group and completed all pre and post PROMs (78.6% female, 71.4% non-Hispanic White, mean age 49). MYMOP® primary symptomatology was fatigue, shortness of breath and "brain fog". Symptoms decreased in interference when compared to pre-group levels (mean difference -1.3 [95% CI-2.2, -.5]). PSS scores decreased (-3.4 [95% CI -5.8, -1.1]), and GAD-2 mean difference was -1.43 (95% CI -3.12, .26). There were no changes in SSS scores of fatigue (-.21 [95% CI -.68,0.25]), waking unrefreshed (.00 [95%CI -.32, -.32]), or trouble thinking (-.21 [95% CI -.78,0.35]). Conclusion: All PROMs were feasible to administer via teleconferencing platform or telephone. The PSS, GAD-2 and MYMOP® are promising PROMs to track Long COVID symptomatology among IMGV participants. The SSS, while feasible to administer, did not change compared to baseline. Larger, controlled studies are needed to determine the efficacy of virtual IMGVs to address the needs of this large and growing population.

Best practices for billing and coding

Billing and coding of telerheumatology encounter types has become more complex, as opportunities to provide telerheumatology services have expanded, with a major increase due to the COVID-19 pandemic. This chapter provides an overview of telerheumatology billing and coding prior to the COVID-19 pandemic. It outlines how geographic criteria for providing telerheumatology care have changed during the COVID-19 pandemic. It identifies specific billing codes, and criteria for their use, which are most relevant to rheumatology care teams. These include discussions of synchronous audio and visual encounters, audio-only encounters, E-visits, virtual check-ins, and interprofessional electronic consults (also known as eConsults). We discuss modifiers and place of service codes which may be required, as well as telehealth codes which may be used by nonphysician members of a rheumatology care team, such as nurse practitioners, physician assistants, physical therapists, and occupational therapists. Finally, this chapter compares payment policies between Medicare and commercial payers, and briefly looks toward possible future trends in telerheumatology coverage policies. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022. All rights reserved.

An Rct of Home-Based Care to Reduce Posthospital Mortality in South Africa: Homelink

Background: In sub-Saharan Africa 23% of people living with HIV (PLWH) die 6 months after discharge from a hospital. Failure to engage in care posthospitalization is associated with mortality. We evaluated whether a series of structured post-hospitalization home visits would reduce mortality among recently discharged PLHIV in South Africa. Method(s): We designed a home visit package with up to 6 home visits starting 1-week post-hospitalization and every 2 weeks as required thereafter. The home visit team consisted of a professional nurse and a counsellor;they used a structured assessment algorithm to evaluate participants' social and medical needs, obtained direction from a doctor for further guidance, collected specimens for laboratory testing, or referred the participant for further evaluation. We compared this intervention to care as usual in a pilot randomized trial conducted at a single hospital in South Africa. The primary goals of the study were to determine feasibility and acceptability and identify opportunities to improve the home visit intervention. We report effectiveness for PLWH based on the primary outcome of all-cause mortality 6 months after discharge from hospital. Result(s): We enrolled 125 PLWH who were randomized 1:1 to home visit intervention or care as usual;14 were late exclusions because they died prior to discharge (n=13) or had a prolonged hospital stay (n=1). In the 111 PLHIV included in the analysis, the median (interquartile range [IQR]) age was 39 (33, 48) years, 69% were women, the median duration of the index hospitalization was 7 (3, 12) days, and primary reasons for the index hospitalization included TB (31%), heart and/or lung related diseases (22%), non-TB/COVID infections (25%), and anemia (15%). Most [96% (n=53/55)] intervention arm participants received >=1 home visits. By six months 14 (13%) participants died: 4 (7%) in home visit intervention arm and 10 (18%) in the care as usual arm (p=0.09). A similar proportion of readmissions occurred by arm: 20 (36%) in the home visit arm and 22 (39%) in care as usual. Conclusion(s): Home visits done after discharge from hospital provided care services to an extremely vulnerable group of PLWH at very high mortality risk . We demonstrated both feasibility and preliminary efficacy of delivering post-hospital visits. Structured home visits appear to be a promising approach that would benefit PLWH. Larger studies in diverse populations with cost effectiveness components are required.

Telerehabilitation in the 'real-world': Implementation of remotely delivered pulmonary rehabilitation

Introduction: Pulmonary rehabilitation (PR) is an effective treatment for people with chronic respiratory disease but is delivered to <5% of eligible individuals. Home-based telerehabilitation achieves similar clinical outcomes to centre-based PR in clinical trials. We aimed to evaluate the clinical implementation of telerehabilitation. Method(s): Suitable individuals with respiratory disease referred for PR at Alfred Health have been offered the option of an 8-week home-based telerehabilitation program (one home visit followed by twice-weekly exercise training sessions, with real time supervision, for 8-weeks). Equipment was provided to patients, as necessary. Standard PR assessments were conducted pre and post program. Program completion was defined as undertaking >=70% of prescribed sessions. Real-world implementation was evaluated against the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Result(s): Reach: Across 2-years (Sept 2020-22), 269 people were referred with 55 (21%) undertaking telerehabilitation (25 female, mean (SD) age 61 (11) years, 6-min walk distance (6MWD) 430 (120) metres, Chronic Respiratory Questionnaire Dyspnoea (CRQD) domain 16 (6)). Participant diagnoses included COPD (n = 11), ILD (n = 15), bronchiectasis (n = 5), asthma (n = 2), post COVID-19 (n = 9), and pulmonary hypertension (n = 4). Forty participants (73%) completed >=70% of prescribed sessions. Effectiveness: Significant and clinically meaningful improvements were demonstrated (CRQD MD 4 (95% CI 1, 6);6MWD MD 24 m (95% CI 8, 41)). Adoption: Training to deliver telerehabilitation and perform home visits was completed by PR clinicians (n = 7 and n = 4 respectively). Implementation: All participants independently supplied Wi-Fi, and 40% used their own exercise equipment or internet-enabled device. Most participants had an in-person home visit (n = 45), and undertook cycle-based training (n = 46). Fifteen participants required additional support for iPad or videoconferencing navigation. There were no serious adverse advents. Maintenance will be evaluated following this pilot period. Conclusion(s): 'Real-world' telerehabilitation achieves clinically meaningful outcomes for patients and provided access to an effective model of PR particularly when centre-based programs were unavailable due to COVID-19 restrictions.

Impact of Telehealth and Process Virtualization on Healthcare Utilization

Technological advancements and the COVID-19 pandemic have catapulted process virtualization across many industries, including healthcare, where telehealth has enabled significant digital transformation of care delivery. Although telehealth has been proposed as a potential solution to improve access to care and restrain runaway healthcare costs, it can increase spending if telehealth use leads to new types of resource utilization. Drawing on the lens of process virtualization theory, we study the impact of telehealth on healthcare utilization by examining visit-level patient data of telehealth use in facilitating e-visits with healthcare providers. On average, a telehealth visit reduces the number of future outpatient visits by 13.6% (or 0.15 visits), equal to a reduction of $239 in total cost within 30 days after the visit. Our results suggest that the benefits of telehealth use are observed primarily among diseases with high virtualization potential. Specifically, patients with mental health, skin, metabolic, and musculoskeletal diseases exhibit a significant reduction of 0.21 outpatient visits per quarter (an equivalent cost reduction of $179) when they are treated via telehealth, suggesting a substitution effect with respect to traditional clinic visits. Our research identifies the boundary conditions that determine the nuanced impact of telehealth on care utilization and shows that its effectiveness depends on the process virtualization potential of different diseases. Our findings have several practical and theoretical implications for fostering telehealth use in a value-based healthcare environment, especially for diseases with high virtualization potential where telehealth use should be promoted to bend the cost curve.

The perceptions of anti-covid-19 practices, experience, satisfaction and behaviour in tourist accommodations in canary Islands

Purpose: The purpose of this chapter is to evaluate and discuss the factors that underpin tourists' perceptions of anti-COVID-19 practices in tourist accommodations and destinations, as well as in tourists' experience, satisfaction and behaviour, in order to make recommendations for managers at hotels and tourist destinations. Design/Methodology/Approach: A survey at tourist accommodations in the Canary Islands was conducted to collect data, and 431 questionnaires were part of the final analysis. The data were analysed with the SPSS27 statistical processing software. Various multivariate techniques such as correlation analysis and factor analysis were used to analyse the data. Findings: The results reveal that anti-COVID-19 practices at the accommodation are the most important for tourists to feel safe in their visit to the destination. The most important factors in the tourists' experience during the pandemic are those related to communication and behaviour. Satisfaction after COVID-19 is perceived higher if places or items for cleaning and disinfestation are provided to tourists and rooms are naturally ventilated, while intentions to visit after COVID-19 are highest to visit local destinations. Practical Implications: The results of the research will support scholars and practitioners to recognise the importance of factors that influence anti-COVID-19 practices, tourists' experience, satisfaction and behaviour during the pandemic. In addition, the research offers policy recommendations for maximum benefits for the tourism industry in the Canary Islands and others tourist destinations. Originality/Value: The chapter was an original primary and exploratory study that surveyed tourists to determine their perceptions of anti-COVID-19 practices, experience, satisfaction and behaviour during the pandemic. The results reveal the most important factors in the construction of the analysed variables, and may be used as a starting point for further hospitality marketing research. © 2022 Rita R. Carballo, Carmelo J. Leon and Maria M. Carballo.

VR tourism experiences and tourist behavior intention in COVID-19: an experience economy and mood management perspective

PurposeVirtual reality (VR) technology is a potential tool for tourism marketers to maintain the attractiveness of their destinations and recover from the COVID-19 pandemic. However, the effectiveness of VR technology in motivating potential tourists' visit intention under lockdown conditions remains unknown. An integrated model based on the experience economy framework and mood management theory was, therefore, used to explain how tourists' VR experiences affect their mood management processes and subsequent behaviors. This research also examined how perceived travel risk influenced the relationship between mood management processes and future decisions.Design/methodology/approachThis study used a cross-sectional design based on a sample collected from a Chinese survey company, Sojump. The author surveyed 285 respondents who had experienced VR tourism activities during the COVID-19 pandemic. The research model was tested using partial least squares–structural equation modeling.FindingsThe results demonstrated that the four dimensions of VR experiences differently affected mood management processes, while perceived travel risk differently moderated the influence of mood management processes on visit intention and VR stickiness. This provides insights for tourism marketers to adapt to the current tourism environment and develop recovery strategies.Originality/valueIn response to gaps in the literature, this research examined the effectiveness of VR technology in driving tourists' visit intention during the COVID-19 pandemic, providing insights for tourism marketers to successfully implement VR tourism and plan timely recovery strategies.

Are Tourists Interested and Finally Decide to Visit Tourist Attraction After Seeing Virtual Tour?

Despite the significant loss, pandemic Covid-19 had been an enabler for digital transformation, specifically in Indonesia. In the tourism industry, the emergence of virtual tours brings fresh fashion for people to spend their leisure time. Following the calming down pandemic, the innovation of virtual tourism or virtual tours can promote specific tourist locations, which are expected to increase interest and decisions to visit. This research intends to discover virtual tours' power to attract visitors. The researcher used a quantitative method with simple linear regression analysis and distributed questionnaires to 104 people who had participated in virtual tours using meeting platform such as Zoom, Google Meet, or Webex. The results of this study indicate that the virtual tour influences the tourists' interest and decision to visit, at a moderate correlation level based on Pearson Correlation Test, with a percentage of 34.6% and 30%, respectively, based on R2 result. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.