Effectiveness of a Web Application for Self-Reporting Health Status in Patients with COVID-19: A Regression...

The COVID-19 pandemic severely strained public health systems. In Japan, Public Health Centers faced administrative bottlenecks in patient monitoring and allocation. To address this, Sapporo City introduced COVIMARU, a web-based self-reporting application. This study quantitatively evaluated the impact of this digital tool on patient care site allocation efficiency.

We conducted a retrospective study using a regression discontinuity design (RDD) using data from Sapporo City's comprehensive COVID-19 database from May 1, 2020, to April 25, 2022. The intervention was COVIMARU implementation for home care on November 12, 2020. The primary outcome was time in days from diagnosis to first care site allocation. We quantified the estimated effect at the cutoff to evaluate the localized impact of the intervention.

The analysis included 130,500 patients. COVIMARU introduction was associated with a significant reduction in mean allocation time at the intervention threshold (estimated effect: -0.96 days (95% CI, -1.39 to -0.20; P = 0.0091). This improvement was not attributable to changes in patient volume. A sensitivity analysis excluding non-working days confirmed the finding (estimated effect: -0.87 days; 95% CI, -1.39 to -0.21; P = 0.008).

The COVIMARU web application significantly reduced patient allocation times, demonstrating that digital health tools can effectively mitigate administrative bottlenecks and improve pandemic response efficiency. Investing in such digital infrastructure is a critical strategy for building resilient public health systems for future emergencies.