Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 15, 2024
Date Accepted: Apr 3, 2025
Warning: This is an author submission that is not peer-reviewed or edited.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.
Factors Affecting Patients’ Use of Telehealth Services: A Cross-Sectional Survey Study
ABSTRACT
Background:
The increasing integration of telehealth services into healthcare systems has transformed patient-provider interactions. Despite numerous benefits that promote health equity and resource allocation, patients’ acceptance and use of telehealth declined. We study the factors from patients’ characteristics perspective that influence the adoption and utilization of telehealth services to enhance healthcare delivery and patient satisfaction.
Objective:
This study examines the direct impact of patient trust, social determinacies of health, and patient self-efficacy on telehealth utilization and the indirect effect of information search confidence, patient-centered communication, and health literacy on telehealth utilization through trust.
Methods:
This paper uses secondary data collected by Health Information National Trends Survey 6 and performs a structural equation modeling method to test the hypotheses. We also addressed common method bias to test for potential measurement errors and ensure the validity and reliability of the results.
Results:
Out of 5,280 participants who were satisfied with Internet access and had at least one doctor visit within the past 12 months, 45.06% used telehealth services in the past year. Trust in providers is influenced by an inverted U-shaped relationship with health-related information search confidence (β= -0.038, p<.001), positively influenced by patient-centered communication (β= 0.141, p<.001), and negatively affected by barriers from health literacy (β= -0.073, p<.001). Trust enhances telehealth utilization (β= 0.047, p<.01), with social determinants of health exerting a positive impact (β= 0.077, p<.001) and health efficacy having a negative impact (β= -0.041, p<.01).
Conclusions:
The study found that trust, social determinants of health, and health efficacy directly impact telehealth utilization. Additionally, telehealth utilization is indirectly influenced by patient characteristics, such as information search confidence and barriers from health literacy, as well as the patient-centered communication environment. The findings emphasize the need for targeted interventions to improve patient health literacy and engagement, thereby promoting the use of telehealth services. Clinical Trial: None
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