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Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study

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 c...

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Autores principales: Orrange, Sharon, Patel, Arpna, Mack, Wendy Jean, Cassetta, Julia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103305/
https://www.ncbi.nlm.nih.gov/pubmed/33822736
http://dx.doi.org/10.2196/28589
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author Orrange, Sharon
Patel, Arpna
Mack, Wendy Jean
Cassetta, Julia
author_facet Orrange, Sharon
Patel, Arpna
Mack, Wendy Jean
Cassetta, Julia
author_sort Orrange, Sharon
collection PubMed
description 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: The aim of this study is 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 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 1624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (173/365, 47.4%) or satisfied (n=129, 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 statistically 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<.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=.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.
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spelling pubmed-81033052021-05-12 Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study Orrange, Sharon Patel, Arpna Mack, Wendy Jean Cassetta, Julia JMIR Hum Factors Original Paper 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: The aim of this study is 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 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 1624 telemedicine visits conducted during this period, 368 (22.7%) patients participated in the survey. Across the study, respondents were very satisfied (173/365, 47.4%) or satisfied (n=129, 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 statistically 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<.01). Visit-related factors associated with patients’ satisfaction included fewer technical issues (P<.001), less concern about privacy (P<.001) or cost (P=.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. JMIR Publications 2021-04-22 /pmc/articles/PMC8103305/ /pubmed/33822736 http://dx.doi.org/10.2196/28589 Text en ©Sharon Orrange, Arpna Patel, Wendy Jean Mack, Julia Cassetta. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 22.04.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Human Factors, is properly cited. The complete bibliographic information, a link to the original publication on https://humanfactors.jmir.org, as well as this copyright and license information must be included.
spellingShingle Original Paper
Orrange, Sharon
Patel, Arpna
Mack, Wendy Jean
Cassetta, Julia
Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title_full Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title_fullStr Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title_full_unstemmed Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title_short Patient Satisfaction and Trust in Telemedicine During the COVID-19 Pandemic: Retrospective Observational Study
title_sort patient satisfaction and trust in telemedicine during the covid-19 pandemic: retrospective observational study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8103305/
https://www.ncbi.nlm.nih.gov/pubmed/33822736
http://dx.doi.org/10.2196/28589
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