Most patients prefer face-to-face hospital appointments over telehealth consultations despite the extra time and costs involved, a survey suggests.
The findings (link here) also identified older age, lower levels of education and a lack of confidence with devices as barriers to telehealth, whereas living further away from a health service and having access to video technology were key enablers.
Doctors from the Royal Melbourne Hospital in Victoria surveyed 754 adults receiving general medical care as inpatients, outpatients and in the community between July and November 2020 when lockdown measures were in place.
Participants were mostly middle-aged and elderly (median age 72, 46% female), with 74% living in metropolitan areas and 55% having never used telehealth before.
More than one-third of patients had been referred to the hospital admission risk program, one quarter had been admitted to acute wards, about one-in-10 had received post-acute care and 7% had been undergoing rehabilitation at the time.
Survey results indicated 81% of patients preferred face-to-face appointments.
“Despite the evidence of high patient acceptance, benefits of telehealth, and pandemic-forced digital transformation, most patients in this study preferred face-to-face appointments,” the authors wrote in Internal Medicine Journal.
“Low acceptance of telehealth could be explained by their older age, or low telehealth competence since nearly half of the patients had not used telehealth previously.
“Another possible explanation could be the predominantly metropolitan-based sample, whose benefits and motivation to do telehealth may be less compared to rural/regional patients.”
They added that overall patients’ sex, living locations, need for interpreters, accomodation, mode of travel and general health did not influence their preference.
Patients also didn’t discount telehealth completely, with almost two-thirds of respondents suggesting that they would be interested in a future telehealth appointment and 41% deeming telehealth to be “as good as” face-to-face visits.
Most patients felt comfortable using their devices for telehealth, with only a small proportion (13%) reporting that they needed help but had no one to help them.
The majority of patients were also not concerned about their safety or privacy when using telehealth (79%) and agreed that the consults would save them time (86%).
Four in five estimated that the time saved would be between two and four hours.
When it came to cost, patients living in metro areas saved an estimated $76.60, while those in regional and rural areas saved $229.80 and $153.20 respectively.
“The study provides a glimpse into where the general population should be divided to prioritise those in need of telehealth,” the authors concluded.
“To ensure equitable and comprehensive telehealth, health services should subsidise those in need of telehealth and target the patients’ barriers to effective telehealth use.”