December 1, 2021 – Most Americans are willing to make video visits to their emergency physicians, but prefer personal visits, according to a new study inJAMA Network Open.
When hypothetical out-of-pocket expenses are taken into account, the newspaper writes, people still value personal care more than video meetings. But the choice is quite cost-sensitive.
A nationally representative survey conducted by researchers at RAND Corp. asked respondents about their preference for telehealth over personal care after the end of the COVID-19 pandemic.
The study panel consisted of 2,080 adults who were provided with Internet-connected devices and were paid to complete the questionnaire. The participants in the weighted sample had an average age of 51 and slightly more than half were women. Minorities were also represented in the panel.
Two thirds of the participants (66.5%) prefer to have at least a few video visits in the future.
But break this and an interesting picture emerges: given the choice between a personal and a video visit for a meeting, which can be resolved in both ways:
- 53% prefer a personal visit.
- 20.9% prefer video visits.
- 26.2% had no preference or did not know.
Forty-five percent of respondents reported having had one or more video visits since March 2020. Of those in this group:
- 44.2% prefer a personal meeting.
- 31.4% prefer video visits.
- Only 2.3% of these people said they did not want to make more video visits in the future.
Of the participants without experience with video visits, 60.2% preferred personal visits and only 12.2% preferred video visits. The others had no preference or did not know.
Younger, richer and better educated people are more likely to prefer video visits. Black respondents prefer personal visits, while Latin American participants are more likely to accept video visits. Racial and ethnic differences are statistically significant. But the differences based on age and income are more significant, says lead author Zachary Predmore, Ph.D., an associate policy researcher at RAND Corp.
Young people, he says, are more likely to prefer video visits because of their knowledge of technology “and their growth in the Internet world.”
Costs make a difference
The survey also asked respondents what type of visit they would prefer if they had to pay more or less out of pocket for one than the other. Those who expressed a preference for a personal or video visit were asked which option they would prefer if the surcharge for their preferred meeting was $ 30, and that for the other method was $ 10. These costs were chosen, the study said, because they represent the lower and upper limits of typical outpatient surcharges.
When personal visits cost $ 20 more than video visits, nearly half (49.8%) of respondents who initially preferred telehealth stay with personal visits, while 23.5% switched to video visits and 26.8 % had no preference or did not know.
When video visits cost $ 20 more than personal visits, 18.9% of respondents who initially preferred telehealth still prefer video visits, while 61.7% switched to personal visits and 19.1% did not. preference or not done I do not know.
Overall, 47% of respondents were willing to pay for a personal visit. Only 20.2% of participants said they were willing to pay for a video visit. Twenty-three percent of the sample rated both methods equally and would probably choose which option is cheaper, the researchers said.
Why patients prefer office visits
“There are several possible explanations for why people place more value on personal care,” says Predmor.
First, he says, they are used to it. It also seems more comprehensive for visits that require a physical examination or for vital signs.
For these reasons, he says, “people can add more value to a personal meeting.”
The paper offers several possible explanations for why people may prefer personal care to more than telehealth. One is that patients may like telehealth in certain circumstances (such as emergency care for minor conditions), but may not perceive video visits as the same value as personal care.
Patients may also perceive that personal visits allow for easier referral for diagnostic tests or that even a high-quality telehealth visit cannot reproduce personal interaction with a clinician.
A third of participants who do not see the role of video visits in their care are usually older, poorer, less educated and more likely to live in rural areas than those who prefer a hybrid model of care. Ironically, the authors note, telehealth can help improve access to care for all of these groups. The results of the study, they said, suggest that “ongoing efforts to promote equitable access to telehealth must take these preferences into account.”
Although this type of people may have other reasons to prefer personal care, Predmore said, building broadband can make a big difference in their choices. “These are closely related but different issues: the desire for video visits and the quality of the internet connection. You need to have both of them to have a successful telehealth visit. “
The main finding of the document, he said, is that among those who have used telehealth, there is a great willingness to do so again. Only 2.3% of these people do not want to do it again.