Jeon Hajae, Lee Jeahyung, Jang Jieun, Choi Mingee, Lee Junbok, Shin Jaeyong
Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
J Med Internet Res. 2025 Jun 16;27:e65304. doi: 10.2196/65304.
The COVID-19 pandemic accelerated global telehealth adoption, prompting the South Korean government to temporarily legalize telemedicine in 2020 and subsequently launch a pilot program in 2023. As South Korea transitions to a postpandemic digital health environment, understanding the factors associated with willingness to use (WTU) and willingness to pay (WTP) for telemedicine and teleconsultation is essential for informing effective policy and service design. However, few studies have explored how preferences vary across clinical domains or user groups.
This study examined the factors that influence WTU and WTP for telemedicine and teleconsultation across 5 clinical domains: dermatological, psychiatric, musculoskeletal, internal medicine, and cancer disorders.
A cross-sectional survey was conducted among 552 participants aged 19-69 years in South Korea, selected through stratified sampling. Multiple logistic regression analysis was used to examine WTU and WTP, considering sociodemographic factors and previous telemedicine experience.
Participants' age, residence, and previous telemedicine experience significantly influenced their WTU and WTP for telemedicine services. WTP increased with age for both telemedicine (P-for-trend=.02) and teleconsultation (P-for-trend=.001). Noncapital residents showed significantly higher WTU for teleconsultation than capital area residents (odds ratio [OR] 1.48, 90% CI 1.03-2.12; P=.07). Participants with previous telemedicine experience showed higher WTU for telemedicine (OR 4.07, 90% CI 1.84-9.04; P=.004) and teleconsultation (OR 2.21, 90% CI 1.21-4.06; P=.03), and higher WTP for telemedicine (OR 2.89, 90% CI 1.84-4.54; P<.001) and teleconsultation (OR 2.76, 90% CI 1.77-4.30; P<.001). WTU and WTP varied by clinical domain: psychiatric care showed the highest WTU (64.5%) and WTP (27.0%) for telemedicine, while cancer disorders showed higher WTU (48.6%) and WTP (24.8%) for teleconsultation than for telemedicine.
WTU and WTP for telemedicine and teleconsultation differ substantially depending on service type, clinical domain, and user characteristics. These findings highlight the importance of considering prior telemedicine experience, regional access disparities, and condition-specific care needs when designing digital health strategies. Accordingly, flexible, user-centered telehealth policies are needed to support service accessibility and equitable implementation in the post-COVID-19 era. The insights from this study can serve as a practical foundation for developing inclusive digital health systems in countries undergoing similar transitions.
新冠疫情加速了全球远程医疗的应用，促使韩国政府在2020年临时将远程医疗合法化，并于2023年随后启动了一个试点项目。随着韩国向疫情后数字健康环境过渡，了解与远程医疗和远程会诊的使用意愿（WTU）及支付意愿（WTP）相关的因素对于制定有效的政策和服务设计至关重要。然而，很少有研究探讨偏好如何因临床领域或用户群体而异。
本研究调查了在皮肤科、精神科、肌肉骨骼科、内科和癌症疾病这5个临床领域中影响远程医疗和远程会诊的WTU及WTP的因素。
通过分层抽样在韩国552名年龄在19至69岁的参与者中进行了一项横断面调查。使用多元逻辑回归分析来研究WTU和WTP，同时考虑社会人口学因素和既往远程医疗经历。
参与者的年龄、居住地和既往远程医疗经历显著影响了他们对远程医疗服务的WTU和WTP。对于远程医疗（趋势P值 = .02）和远程会诊（趋势P值 = .001），WTP均随年龄增长而增加。非首都地区居民对远程会诊的WTU显著高于首都地区居民（优势比[OR] 1.48，90%置信区间1.03 - 2.12；P = .07）。有既往远程医疗经历的参与者对远程医疗（OR 4.07，90%置信区间1.84 - 9.04；P = .004）和远程会诊（OR 2.21，90%置信区间1.21 - 4.06；P = .03）的WTU更高，对远程医疗（OR 2.89，90%置信区间1.84 - 4.54；P < .001）和远程会诊（OR 2.76，90%置信区间1.77 - 4.30；P < .001）的WTP也更高。WTU和WTP因临床领域而异：精神科护理对远程医疗的WTU最高（64.5%）和WTP最高（27.0%），而癌症疾病对远程会诊的WTU（48.6%）和WTP（24.8%）高于远程医疗。
远程医疗和远程会诊的WTU和WTP因服务类型、临床领域和用户特征而有很大差异。这些发现凸显了在设计数字健康战略时考虑既往远程医疗经历、地区获取差异和特定病情护理需求的重要性。因此，需要灵活的、以用户为中心的远程医疗政策来支持后新冠时代的服务可及性和公平实施。本研究的见解可为正在经历类似转型的国家发展包容性数字健康系统提供实际基础。
