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Assessment of Patient Preferences for Telehealth in Post–COVID-19 Pandemic Health Care

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
Key Points

Question  What role do US adults envision for telehealth in their future medical care?

Findings  In this survey study of 2080 adults, most respondents were willing to use video visits in the future but, when presented with the choice between an in-person or a video visit for nonemergency care, most preferred in-person care. Willingness to pay for preferred visit modality was higher for those who preferred in-person care, and those who preferred video visits were more sensitive to out-of-pocket cost.

Meaning  The findings of this study suggest that awareness of patient preferences will help define telehealth’s role in US health care after the COVID-19 pandemic.

Abstract

Importance  Telehealth use greatly increased in 2020 during the first year of the COVID-19 pandemic. Patient preferences for telehealth or in-person care are an important factor in defining the role of telehealth in the postpandemic world.

Objective  To ascertain patient preferences for video visits after the ongoing COVID-19 public health emergency and to identify patient perceptions of the value of video visits and the role of out-of-pocket cost in changing patient preference for each visit modality.

Design, Setting, and Participants  This survey study was conducted using a nationally representative sample of adult members of the RAND American Life Panel. The data were obtained from the American Life Panel Omnibus Survey, which was fielded between March 8 and 19, 2021.

Main Outcomes and Measures  Preferences for video visits vs in-person care were analyzed in the survey. The first question was about participants’ baseline preference for an in-person or a video visit for a nonemergency health issue. The second question entailed choosing between the preferred visit modality with a cost of $30 and another modality with a cost of $10. Questions also involved demographic characteristics, experience with video visits, willingness to use video visits, and preferences for the amount of telehealth use after the COVID-19 pandemic.

Results  A total of 2080 of 3391 sampled panel members completed the survey (participation rate, 61.3%). Participants in the weighted sample had a mean (SE) age of 51.1 (0.67) years and were primarily women (1079 [51.9%]). Most participants (66.5%) preferred at least some video visits in the future, but when faced with a choice between an in-person or a video visit for a health care encounter that could be conducted either way, more than half of respondents (53.0%) preferred an in-person visit. Among those who initially preferred an in-person visit when out-of-pocket costs were not a factor, 49.8% still preferred in-person care and 23.5% switched to a video visit when confronted with higher relative costs for in-person care. In contrast, among those who initially preferred a video visit, only 18.9% still preferred a video visit and 61.7% switched to in-person visit when confronted with higher relative costs for video visits.

Conclusions and Relevance  This survey study found that participants were generally willing to use video visits but preferred in-person care, and those who preferred video visits were more sensitive to paying out-of-pocket cost. These results suggest that understanding patient preferences will help identify telehealth’s role in future health care delivery.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: October 4, 2021.

Published: December 1, 2021. doi:10.1001/jamanetworkopen.2021.36405

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Predmore ZS et al. JAMA Network Open.

Corresponding Author: Zachary S. Predmore, PhD, RAND Corporation, 20 Park Plaza, Ste 920, Boston, MA 02116 (zpredmor@rand.org).

Author Contributions: Dr Predmore had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Predmore, Breslau, Fischer, Uscher-Pines.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Predmore, Breslau, Uscher-Pines.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Predmore, Roth, Breslau.

Obtained funding: Fischer.

Administrative, technical, or material support: Fischer.

Supervision: Predmore, Breslau, Fischer, Uscher-Pines.

Conflict of Interest Disclosures: None reported.

Funding/Support: This research was funded by gifts from RAND Corporation supporters and income from operations.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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