Patient Satisfaction With Telehealth Visits in Rural Compared With Urban Communities: Single-Center Study

Abstract Background Studies performed in urban communities with access to technology suggest high patient satisfaction with telehealth. While virtual visits can increase the reach of clinical practice in rural communities, technological barriers may reduce patient satisfaction. Objective This study aimed to compare satisfaction with telehealth visits between patients living in rural and urban communities. Methods A telephone survey was developed and administered to hepatology patients seen at outpatient clinics from March 2020 through March 2021. Patient characteristics and survey responses were compared by urban and rural location as defined by the census tract based on zip code using univariable and multivariable logistic regression. Results Of 400 patients, 164 (41%) completed the survey. Compared with urban patients, rural patients had twice the transportation time to clinic (mean 59, SD 35 vs mean 30, SD 15 min) and were more likely to cancel due to transportation issues (21/48, 46% vs 15/116, 13%). Rural patients reported less proficiency with technology and more technical difficulties, including an inability to log on to the portal or access the camera or microphone (35/48, 75% vs 29/116, 25%) and less comfort with their devices (26/48, 54% vs 10/116, 9%). Overall, urban patients were more likely to prefer telehealth (adjusted odds ratio 5.20, 95% CI 2.15‐13.7) and were more satisfied with telehealth vs in-person visits than rural patients (72/116, 62.1% vs 10/48, 20.8%). Conclusions Rural patients reported more technical challenges with telehealth and more transportation issues than urban patients but favored in-person hepatology visits. Urban patients were more satisfied with telehealth visits compared with in-person visits. Research is needed to improve telehealth delivery and satisfaction for rural patients.