Telehealth use after pandemic is uncertain, study finds

Telehealth use, including video visits, spiked at the start of the COVID-19 pandemic, as both doctors and patients sought to minimize in-person contact. But a new survey finds that Americans are of two minds about video visits for non-emergency health care after the pandemic ends: they don’t mind using them, but given the choice, most would still prefer in-person visits, even if they have to pay more out-of-pocket than for a video visit.

Researchers asked 2,080 people to rate their willingness to use video visits in the future on a scale of one (unwilling) to five (very willing) if out-of-pocket costs were not a factor. More than 61% rated their willingness as a four or five, while 16% responded with a one or two.

But asked their preference for the amount of video visits they wanted after the pandemic, 63.6% said they wanted “none” or “a little,” with the rest saying they wanted “some” or “as much as possible.”

When told they’d have to pay $30 out-of-pocket for an in-person visit versus $10 for a video visit, half of those who initially preferred an in-person visit maintained their preference, and 23.5% switch to a video visit. The remainder had no preference.

In contrast, when those who initially preferred a video visit were told it would cost more than an in-person visit, only 19% still wanted a video visit, while 61.7% switched their preference to in-person. The authors say the difference in perceived value suggest that while patients may like telehealth in some circumstances, such as care for minor acute conditions, they might not perceive it as having the same value as in-person care.

The authors note that the results have troubling implications for the hope that video visits can result in more care for underserved populations, such as racial and ethnic minorities or people living in rural areas: 49.3% of Black/African American respondents, and 58.6% of Hispanic/Latinos said they prefer in-person visits, while 16.5% and 23%, respectively, expressed a preference for video visits.

Similarly, 56% of respondents living in rural areas or cities with fewer than 50,000 residents preferred in-person visits, while 17.6% wanted video visits. “Findings of this survey suggest that these [underserved] populations may be the least likely to demand it [video visits] and that ongoing efforts to promote equity of access to telehealth need to consider these preferences,” they write.

The study, “Assessment of Patient Preferences for Telehealth in Post-COVID-19 Pandemic Health Care,” was published December 1, 2021 on JAMA Network Open.