Lunova Tetiana, Hurndall Katherine-Helen, Crespo Roberto, Howitt Peter, Leis Melanie, Grailey Kate, Darzi Ara, Neves Ana L
NIHR North West London Patient Safety Research Collaboration (PSRC), Institute of Global Health Innovation, Imperial College London, London, UK.
NIHR Applied Research Collaboration (ARC) NWL, Imperial College London, London, UK.
J Telemed Telecare. 2025 Sep;31(8):1175-1185. doi: 10.1177/1357633X241255411. Epub 2024 May 20.
IntroductionSince 2021, the world has been facing a cost-of-living crisis which has negatively affected population health. Meanwhile, little is known about its impact on patients' preferences to access care. We aimed to analyse public preference for the modality of consultation (virtual vs face-to-face) before and after the onset of crisis and factors associated with these preferences.MethodsAn online cross-sectional survey was administered to the public in the United Kingdom, Germany, Italy and Sweden. McNemar tests were conducted to analyse pre- and post-crisis differences in preferences; logistic regression was used to examine the demographic factors associated with public preferences.ResultsSince the onset of crisis, the number of people choosing virtual consultations has increased in the United Kingdom (7.0% vs 9.5% < 0.001), Germany (6.6% vs 8.6%, < 0.008) and Italy (6.0% vs 9.8%, < 0.001). Before the crisis, a stronger preference for virtual consultations was observed in people from urban areas (OR 1.28, 95% CI 1.05-1.56), while increasing age was associated with a lower preference for virtual care (OR 0.966, 95% CI 0.961-0.972). Younger people were more likely to switch to virtual care, while change to face-to-face was associated with younger age and lower income (OR 1.34, 95% CI 1.12-1.62). Older adults were less likely to change preference.ConclusionsSince the onset of the cost-of-living crisis, public preference for virtual consultations has increased, particularly in younger population. This contrasts with older adults and people with lower-than-average incomes. The rationale behind patients' preferences should be investigated to ensure patients can access their preferred modality of care.
引言
自2021年以来，全球一直面临生活成本危机，这对民众健康产生了负面影响。与此同时，对于其对患者就医偏好的影响却知之甚少。我们旨在分析危机爆发前后公众对会诊方式（虚拟会诊与面对面会诊）的偏好以及与这些偏好相关的因素。
方法
对英国、德国、意大利和瑞典的公众进行了一项在线横断面调查。采用麦克尼马尔检验分析危机前后偏好的差异；使用逻辑回归分析与公众偏好相关的人口统计学因素。
结果
自危机爆发以来，英国（7.0%对9.5%，<0.001）、德国（6.6%对8.6%，<0.008）和意大利（6.0%对9.8%，<0.001）选择虚拟会诊的人数有所增加。危机前，城市地区的人对虚拟会诊的偏好更强（OR 1.28，95%CI 1.05 - 1.56），而年龄增长与对虚拟医疗的偏好降低相关（OR 0.966，95%CI 0.961 - 0.972）。年轻人更有可能转向虚拟医疗，而转向面对面会诊与年轻和低收入相关（OR 1.34，95%CI 1.12 - 1.62）。老年人改变偏好的可能性较小。
结论
自生活成本危机爆发以来，公众对虚拟会诊的偏好有所增加，尤其是在年轻人群体中。这与老年人和收入低于平均水平的人群形成对比。应调查患者偏好背后的原因，以确保患者能够获得他们喜欢的就医方式。
