Patient Satisfaction With Telemedicine Among Vulnerable Populations in an Urban Ambulatory Setting

Objective

To compare patient satisfaction between telemedicine and in-person visits for historically vulnerable groups at risk of worse experiences with telemedicine.

Patients and Methods

Individuals seen at Mount Sinai Beth Israel Department of Medicine ambulatory practices from April 23, 2020, to March 7, 2023, who completed a post-video or in-person appointment survey. Primary outcomes were: satisfaction with ability to get appointments, quality of time with doctor, explanations from care team, and likelihood to recommend practice. Patients were subdivided by age, gender, English proficiency, and clinician type.

Results

Among 8948 in-person and 1101 telemedicine visits, telemedicine scored lower in how the clinical team explained care to patients in the first year, but differences diminished thereafter. Within subgroups, those who were older than 65 years, non-English speakers, and seen by a faculty physician had a lower satisfaction with telemedicine that improved after the first year. Lack of English proficiency was a predictor of lower satisfaction in both types of visits, whereas older age and faculty physician were predictors of higher in-person visit satisfaction, and medicine subspecialties were linked to better telehealth visit satisfaction.

Conclusion

These findings suggest improved patient satisfaction with time after the initial COVID-19 expansion, both broadly and within subgroups, but overall differences between in-person and telehealth visits do not appear to be clinically significant. There appear to be differences among certain populations that warrant further study and may require targeted intervention to maintain quality of care.