Telemedicine adoption before, during, and after COVID-19: The role of socioeconomic and built environment variables

The COVID-19 pandemic has led to a significant shift in healthcare delivery, with telemedicine emerging as an important additional service provision channel. This study introduces a novel methodological framework, combining a multiperiod multivariate binary probit (MBP) system and a cross-sectional MBP system, to investigate telemedicine adoption trends, as well as the facilitators and deterrents of adoption. The analysis utilizes data from a three-wave COVID Future Survey (April 2020-November 2021), supplemented by population density and healthcare-related establishment data. The results reveal a generational digital divide, with older adults exhibiting lower adoption rates due to technological barriers and preferences for traditional healthcare interactions. The study also highlights the role of the presence of children, income, transportation access, employment status, and residential location characteristics in telemedicine adoption. Notably, individuals without vehicle access or living in areas with lower geographic accessibility to healthcare providers are more likely to adopt telemedicine, suggesting its potential to reduce healthcare access disparities. The analysis of telemedicine facilitators and deterrents underscores the importance of accessibility, lifestyle preferences, privacy and security issues, technological confidence, and mobility constraints. The study provides valuable insights into policy implications across the public health, telecommunication, transportation, and urban planning sectors.