Most Americans are willing to continue using telehealth after the COVID-19 pandemic but prefer in-person care, according to survey findings published in JAMA Network Open. Those who preferred telehealth visits were more sensitive to paying out-of-pocket costs, as a $20 increase was associated with more people switching from video visits to in-person care.
“Patients may like telehealth in certain circumstances such as when they need care for minor health issues,” said lead author Zachary S. Predmore, PhD, an associate policy researcher at the nonprofit RAND Corporation. “But their willingness to use telehealth is very sensitive to costs. Patients may not perceive video visits to have the same value as in-person health care.”
Although telehealth use markedly increased during the COVID-19 pandemic, it is unclear how this technology will be used after the pandemic, with early evidence suggesting that telehealth use is decreasing as providers and patients resume in-person care. Federal programs such as Medicare and private insurers are weighing whether and how to pay for routine telehealth in the future.
Study Design and Key Findings
The researchers surveyed a representative sample of 2080 American adults (mean age, 51 years; 52% women) to ask about their experiences with telehealth and their preferences for in-person care or video visits for nonemergency care in the future under different scenarios.
More than half of survey participants (53%) preferred in-person care when out-of-pocket costs were not a factor but 67% also preferred at least some video visits in the future. Those who were younger, had higher incomes, and had higher education levels were more likely to prefer telehealth visits.
“The results show that although many participants used telehealth for the first time during the pandemic out of necessity, their experiences were positive enough for them to use such services again,” Dr Predmore said. Only 2% of those who previously had a video visit were unwilling to do so again.
Costs Play Into Preferences
Among those who initially preferred an in-person visit when out-of-pocket costs were not a factor, 23.5% switched their preference to a video visit when confronted with higher relative costs for in-person care. However, among those who initially preferred a video visit, 62% switched their preference to an in-person visit when confronted with higher relative costs for video visits.
Approximately 34% of participants did not see any role for telehealth in their medical care; these patients were generally older, had lower incomes, lived in more rural areas, and had lower education levels.
“It is not clear whether these patients do not value telehealth as much as in-person care or do not view telehealth as feasible or practical given personal circumstances, such as not having access to a broadband internet connection,” Dr Predmore said.
“Improving the delivery of telehealth is important, but that is only part of the story,” Dr Predmore concluded. “Being aware of patient preferences will help to identify the best role for telehealth in post-pandemic health care delivery.”
Predmore ZS, Roth E, Breslau J, Fischer SH, Uscher-Pines L. Assessment of patient preferences for telehealth in post-COVID-19 pandemic health care. JAMA Netw Open. 2021;4(12):e2136405. doi:10.1001/jamanetworkopen.2021.36405
Rand Corporation. Patients OK Using Telehealth in Future, but Cost May Be Key to Maintaining Pandemic Boost in Use. December 1, 2021. Accessed December 1, 2021. https://www.rand.org/news/press/2021/12/01.html