RESEARCH ARTICLE Curr Res Integr Med Vol.6 No.3 2021 1 Department of Population Health Sciences, Health Policy and Economics, Cornell University, New York, United States; 2 The Center for Enterprise and Society (CES), University of Liberal Arts Bangladesh (ULAB), Dhaka, Bangladesh Correspondence: Saanjaana Rahman, Department of Population Health Sciences, Health Policy and Economics, Cornell University, New York, United States, E-mail: sar4006@ med.cornell.edu Received: September, 22, 2021, Accepted: October 06, 2021, Published: October 13, 2021 This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact reprints@pulsus.com 12 Impact of telehealth in Bangladesh during the COVID-19 pandemic in 2020 Saanjaana Rahman 1* , Sajid Amit 2 INTRODUCTION T elehealth is the use of electronic information and technologies to support long-distance healthcare services from healthcare workers to patients remotely at any time and place. Bangladesh is a developing country with only 6 doctors per 10,000 patients. The healthcare sector is heavily focused in Dhaka, the capital city of Bangladesh; although, 64% of the population resides in rural areas and patients need to travel long distances to access healthcare services. Telehealth is allowing healthcare workers to see patients virtually in locations that were not accessible previously, and this has reduced cost and time as well as saved lives. With 60.3% of the total market as of 2019, North America is currently the largest telehealth market and is expected to remain so until 2025; however, the Asian market is predicted to grow fast. Bangladeshi Telehealth practices began in 1999 through the Center for Rehabilitation of Paralyzed (CRP) by Swinfen Charitable Trust of the UK, which used store and forward-based telemedicine with digital cameras for taking images, but no real-time technology was applied. However, lack of marketing, poor logistics, and little connectivity meant that this approach did not succeed. In 2020, the COVID-19 pandemic led both government and non-government bodies to initiate telehealth for delivering patient care all over the country. Through a public project under the Directorate General of Health Services (DGHS), high-quality telehealth services were established at Bangabandhu Sheikh Mujib Medical University and the National Institute of Cardiovascular Diseases with 3 district hospitals (Shatkhira, Nilphamari, and Gopalganj) and 3 sub-district hospitals (Pirgonj, Dakope and Debhata) [1]. Among private projects, Praava Health, Evercare, Maya, and Telenor Health are some of the successful hospitals and organizations leading telehealth services in Bangladesh. Although few people used telehealth services in the pre-COVID-19 period, the pandemic has led to a significant rise in telehealth services in Bangladesh. COVID-19 testing rate in Bangladesh during the initial outbreak was only 0.34%, the second lowest in South Asia, only after the war torn nation- Afghanistan. This also led people to stay home and seek medical assistance through virtual channels as many wanted to prevent catching the virus. During the pandemic, a rising percentage of individuals in Bangladesh were turning to telehealth as it may provide more convenience and access to care for online consultations while minimizing the risks of virus transmission that may result from going to a healthcare provider. This study will leverage a timely national experiment to evaluate the impact of telehealth across the Bangladeshi population. Despite the overall growth in telehealth in this country, it is unclear whether telehealth utilization has increased for patient populations for all age groups and both genders in 2020. The research question and hypothesis are as follows. Research question What impact did telehealth use have on patients’ healthcare satisfaction in Bangladesh during the COVID-19 pandemic in 2020? Telehealth use is experiencing unprecedented growth. However, telehealth users’ demographics are unclear in Bangladesh. The research question aims to assess the demographics and impacts of telehealth use on healthcare satisfaction compared to in-person appointments with healthcare providers for healthcare utilization. Conceptual framework The conceptual framework as shown in Figure 1 shows hypothesized associations of socioeconomic and demographic factors that affect health outcomes. In the socioeconomic and demographic factors, the phenomenon indicates a patient’s absolute and relative position in society, including prestige, education, occupation, and wealth. For example, employment provides income, which influences choices of housing (residential and community), relationships among friends and family, food, medical care, and more. However, employment depends on education because the higher the education a person attains, the better employment opportunity he/she will typically receive. Employment sometimes depends on the gender/sex of an individual, considering there is a glass ceiling for women in Bangladeshi society. For example, females often experience discrimination in the job market and often receive less payment compared to men in the same position. This study will leverage a timely national experiment to evaluate the users of telehealth across the Bangladeshi population. We obtained de-identified data for 200 patients among outpatient telehealth visits from Global Health Data Exchange as it captures telehealth use throughout Bangladesh. The analysis showed that 92% of participants were males in the study population, and had a higher dependency on telehealth than 8% of the females. We found that the youngest age group, had the highest dependence on telehealth, compared to any other age group in Bangladesh. The lowest dependence was among the oldest age group of 45 years and above. There was strong association between patient satisfaction and telehealth use. Key Words: Telehealth; Healthcare utilization; COVID-19 pandemic Rahman S, Amit S. Impact of telehealth in Bangladesh during the COVID-19 pandemic in 2020. Curr Res Integr Med. 2021;6(3):12-15. Telehealth is allowing healthcare workers to see patients virtually in locations that were not accessible previously, and this has reduced cost and time as well as saved lives. Bangladesh is a developing country with only 6 doctors for every 10,000 patients. Due to the COVID-19 pandemic, a rising percentage of individuals in Bangladesh are turning to telehealth as it may provide more convenience and access to care for online consultations while minimizing the risks of virus transmission that may result from going to a healthcare provider. Our research question was to see if there was any impact of telehealth utilization on patient satisfaction during the pandemic in 2020. Figure 1) Conceptual framework of socioeconomic and demographic factors that affect health outcomes