A nationally representative study on telehealth has revealed demographic variations in usage, with higher prevalence among females, individuals aged 45 to 59 with at least a college degree, Hispanics, and those with physical conditions or depression. The study also found motivations for telehealth use varied, including clinician recommendation, convenience, infection avoidance, seeking medical advice, and the desire to include others, emphasizing the importance of tailored approaches in developing comprehensive telehealth policies. Telehealth usage increased greatly during the COVID-19 pandemic. While research has been dedicated to examining patient utilization and perspectives on telehealth, the motivations driving patients to use telehealth have remained less transparent, as highlighted by the study authors. However, the creation of appropriate payment policies and the formulation of informed decisions about telehealth requires a detailed understanding of patients’ perceptions of its value, rooted in the motivations influencing its use. The study also highlights a substantial 766% surge in telehealth investments within the first three months of the COVID-19 pandemic for patients with private insurance. Waivers extended telehealth access to Medicare beneficiaries, with over a third of behavioral health visits conducted virtually in 2020. However, literature emphasized barriers such as digital literacy and access challenges, particularly for older adults. Ongoing discussions on payment policies unfolded, and as of 2023, 17 states mandate parity in reimbursements for telehealth and in-person visits. Despite extensive research on patient perspectives, motivations for telehealth use remain insufficiently explored, emphasizing the need to understand these factors as the public health emergency concludes and shape post-pandemic care delivery decisions accordingly.
Population-level weights were applied in this study to provide nationally representative estimates. The researchers first summarized the demographic and health characteristics of the entire sample, comparing the proportion of telehealth users across different demographic groups. The motivations for telehealth use were then explored through detailed analysis, utilizing multivariable logistic regression models to understand the relationships between covariates and both telehealth use and the reported motivations. The results, analyzed using Stata version 18 (StataCorp LLC), revealed that around one-third of respondents aged 18 to 29 years and 60 years or older had utilized telehealth, with higher prevalence among females and individuals with depression. Telehealth users, constituting 39.1% of respondents, sought care for various needs such as minor illnesses, chronic conditions, and mental or behavioral health issues. Logistic regression models unveiled that respondents aged 45 to 59 years, females, those with at least a college degree, Hispanics, and individuals with physical conditions or depression were greatly more inclined to use telehealth.
The researchers’ analysis of telehealth motivations revealed that users were primarily driven by their clinician’s recommendation (73.6%), convenience (65.7%), the desire to avoid infections (49.5%), seeking medical advice (29.0%), and the ability to include others (23.1%). Respondents over 60 years were less likely to use telehealth based on clinician recommendation. Those with depression were notably more inclined to use telehealth for its convenience and to avoid exposure to infections. Hispanic respondents were more likely to leverage telehealth for infection avoidance. Despite a higher likelihood of telehealth use among females and those with higher education, these groups were less motivated to include others in their telehealth visits. The analysis of patient characteristics further illuminated that being female, having health insurance, multiple physical health conditions, depression, more education, and residing in a metropolitan area correlated with a heightened likelihood of using telehealth. These findings aligned with previous analyses during the COVID-19 pandemic, emphasizing the persistent impact of broadband and internet connectivity issues, especially in non-metropolitan areas. Surprisingly, Hispanic respondents exhibited higher telehealth usage, challenging prior studies. While older adults were more likely to use telehealth than their younger counterparts, barriers to their utilization indicated a need for additional explanations of telehealth benefits for this demographic. Among adults seeking mental health support, telehealth was a greatly preferred option. Those with depression not only demonstrated increased telehealth usage but also exhibited various motivations, emphasizing the potential benefits of sustained access to telehealth mental health care. The study indicated the importance of further exploring telehealth as a mode for patient triage and emphasized the importance of policies enabling the inclusion of family caregivers in telehealth visits. Despite limitations such as the cross-sectional design and self-reported data, the study provided valuable insights into patient characteristics and motivations for telehealth use.
The researchers emphasize the importance of states considering the diverse perceptions of telehealth value among patients when formulating telehealth policies. This insight into telehealth motivations can inform the creation of policies that improve patient autonomy and comfort with healthcare delivery, especially considering the variations in motivations among different patient groups, highlighting the necessity for customized approaches. While some adults, particularly those seeking mental health treatment, may highly value telehealth options, others may find them less appealing. This study contributes to the evolving comprehension of telehealth’s value beyond its pandemic utility, emphasizing the importance of further research into patient experiences and longitudinal trends in telehealth use. Policymakers should leverage this understanding of telehealth motivations to formulate comprehensive and inclusive telehealth practice and payment policies.
