JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic rapidly changed the landscape of clinical practice in the US; telehealth became an essential mode of healthcare delivery, yet many components of telehealth usage remain unknown years after the disease’s emergence.

Objective:

We aim to comprehensively assess telehealth use and its associated factors in the US.

Methods:

This cross-sectional study used a nationally representative survey (Health Information National Trends Survey), administered to US adults (≥18 years) and collected March through November 2022. To assess telehealth prevalence, perceptions, satisfaction, care purpose, we conducted weighted descriptive analyses. To identify the sub-populations with low adoption of telehealth we developed a weighted multivariable logistic regression model.

Results:

Among a total of 6,252 survey participants, 39.3% reported telehealth use in the past 12 months (video 17.8%; audio 11.6%). The most prominent reason for not using telehealth was due to telehealth providers failing to offer this option (63%, n=2,200). The most common reason for respondents not using offered telehealth services was preference for in-person care (84.4%, n=527). Primary motivations to use telehealth was providers’ recommendation (72.7%, n=1,716) and convenience (65.6%, n=1,516), mainly for acute minor illness (29.7%, n=600) and chronic condition management (21.4%, n=583), yet care purposes were differed by age, race/ethnicity, and income. The satisfaction rate was predominately high with no technical problems (80.5%, n=1,829), comparable care quality to in-person care (75.0%, n=1,779), and no privacy concerns (83.7%, n=1,958). Younger individuals (ORs=1.48-2.23, 18-64 vs. ≥75 years), females (OR=1.33, 1.09-1.61), Hispanics (OR=1.37, 1.05-1.80 vs. non-Hispanic White), those with more education (OR=1.72, 1.03-2.87, college graduate or more vs. less than high school), unemployed (OR=1.25, 1.02-1.54) or insured individuals (OR=1.83, 1.25-2.69), or those with poor general health status (OR=1.66, 1.30-2.13) had higher odds of using telehealth.

Conclusions:

To our best knowledge, this is among the first studies that examine patient factors around telehealth use, including motivations to use, perceptions, satisfactions, and care purpose of telehealth, and associated sociodemographic factors with telehealth adoption, using a nationally representative survey. The wide array of descriptive findings and identified associations will help providers and health systems understand the factors that drive patients towards or away from telehealth visits as the technology becomes more routinely available across the US, providing future directions of telehealth use and telehealth research. Clinical Trial: N/A