Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 14, 2022
Date Accepted: Jul 31, 2022
Date Submitted to PubMed: Aug 2, 2022
Factors Associated With the Utilization of Outpatient Virtual Clinics: Retrospective Observational Study Using Multilevel Analysis
ABSTRACT
Background:
Although the coronavirus disease 2019 (COVID-19) pandemic has accelerated the adoption of telemedicine and virtual consultations globally, complex factors that may affect the use of virtual clinics are still unclear.
Objective:
This study aimed to identify factors associated with the utilization of virtual clinics in the experience of virtual clinic service implementation in Taiwan.
Methods:
We retrospectively analyzed a total of 187,742 outpatient visits (187,742 in-person visits and 10,972 virtual visits) completed at a large general hospital in Taipei City from May 19 to July 31, 2021 after rapid implementation of virtual outpatient clinic visits due to the COVID-19 pandemic. Data of patients’ demographic characteristics, disease chronicity, physicians’ features and subspecialties were collected; and physicians’ opinions regarding virtual clinics were surveyed and evaluated using a 5-point Likert scale. Multilevel analysis was conducted to determine the factors associated with the utilization of virtual clinics.
Results:
Patient/visit-level, physician-level, and department-level factors accounted for 67.6%, 11.1%, and 21.4% of the total variance in utilization of virtual clinic, respectively. Female gender (odds ratio [OR]=1.27, P<.001), residing at a greater distance away from the hospital (OR=2.36 if distance ≥50 km, P<.001; OR=3.95 if extensive travel required, P<.001), reimbursement by the National Health Insurance (OR=7.29, P<.001), seeking care for a chronic disease (OR=1.33, P<.001), physician’s positive attitude about virtual clinics (OR=1.50, P=.002), and visits within certain departments including the heart center, psychiatry, and internal medicine (OR=2.55, P =.004) were positively associated with the utilization of virtual clinics.
Conclusions:
Our study demonstrates that factors at different levels contributed to the utilization of virtual clinics. The findings may help direct policymaking for expanding the use of virtual clinics, especially in countries struggling with the development and promotion of telemedicine virtual clinic services.
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