Patient Preferences for Video and In-clinic Consultations in German Primary Care: A Discrete Choice Experiment

Abstract

BACKGROUND: The popularity of video consultations in healthcare has accelerated during the Coronavirus-19 pandemic. More and more physicians began offering video consultations at their clinics, and the market of commercial telemedicine platforms proliferated. Despite increased availability and obvious benefits, such as convenience, many patients remain hesitant about using video consultations.OBJECTIVE: This thesis aims to evaluate the relative importance of the consultation mode in a patient’s appointment choice and provide insights to practitioners and policymakers to promote video consultation uptake. This study further investigates individual characteristics that may affect preferences for video over in-clinic consultations.METHODS: An online self-administered discrete choice experiment (DCE) was conducted with adults living in Germany through a crowdsourcing provider in November 2020. Based on interviews with patients and healthcare experts, consultation mode, the waiting time until the next available appointment, the waiting time on appointment day, opening hours, and continuity of care were included as attributes. Mixed logit models were used to analyze the choice data. Predictive analyses based on individual choice probabilities were performed to determine the impact of univariate and multivariate attribute level changes on the choice probability of a video compared to a typical in-clinic consultation and opt-out.RESULTS: A total of 459 participants started the survey, of which 350 (76.3%) complete and valid responses were included. The sample was representative of the German adult population in gender and age. Among the included participants, 79 (22.6%) had experience with telemedicine. Participants largely preferred in-clinic over video consultations (β=-1.429, PCONCLUSION: This study provides insights on the effect of consultation mode on appointment choice in a time when telemedicine gains momentum. The results of this DCE suggest that policymakers and providers of video consultations should focus on increasing the level of continuity of care and decreasing the waiting time until the next available appointment to prompt the adoption of video consultations. Although participants preferred in-clinic over video as a consultation mode per se, the demand for video consultations can be increased significantly by improving the attributes of video consultations.