Accepted for/Published in: JMIR Human Factors
Date Submitted: Mar 7, 2021
Date Accepted: Apr 5, 2021
Date Submitted to PubMed: Apr 23, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Patient Satisfaction and Trust in Telemedicine during the COVID-19 Pandemic
ABSTRACT
Background:
Los Angeles County is a hub for COVID-19 cases in the United States. Academic health centers rapidly deployed and leveraged telemedicine to permit uninterrupted care of patients. Telemedicine enjoys high patient satisfaction, yet little is known about the level of satisfaction during a crisis and to what extent patient or visit-related factors and trust play when in-person visits are eliminated.
Objective:
To examine correlates of patients’ satisfaction with a telemedicine visit.
Methods:
In this retrospective observational study conducted in our single-institution, urban, academic medical center in Los Angeles, internal medicine patients aged 18 years and above who completed a telemedicine visit between March 10th and April 17th, 2020 were invited for a survey (n=1624). Measures included patient-demographics, degree of interpersonal trust in patient-physician relationships using the” Trust in Physician Scale,” and visit-related concerns. Statistical analysis used descriptive statistics, Spearman rank-order correlation, and linear and ordinal logistic regression.
Results:
Of 1,624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (47.4%) or satisfied (35.3%) with their telemedicine visit. Higher physician trust was associated with higher patient satisfaction (Spearman correlation r=0.51, P<.001). Visit-related factors with significant correlation with trust in physician score were technical issues with the telemedicine visit (r=-0.16), concerns about privacy (r=-0.19), concerns about cost (r=-0.23), satisfaction with telemedicine convenience (r=0.41), and amount of time spent (r=0.47) (all P<0.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=0.02), and successful face to face video (P<.001). The only patient variable with a significant positive association was income and level of trust in physician (r=0.18, P<.001). Younger age was associated with higher satisfaction with the telemedicine visit (P=.005).
Conclusions:
There have been calls for redesigning primary care after the COVID-19 pandemic and for the widespread adoption of telemedicine. Patients’ satisfaction with telemedicine during the COVID-19 pandemic is high. Their satisfaction is shaped by the degree of trust in physician and visit-related factors more so than patient factors. This has widespread implications for outpatient practices and further research into visit-related factors and the patient-provider connection over telemedicine is needed. Clinical Trial: IRB Approval University of Southern California July 2020 HS-20-00479
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