A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits
Abstract
:1. Introduction
2. Materials and Methods
2.1. Survey
2.2. Variables
- Sociodemographic variables: age, gender, place of residence, level of education, marital status, vocational status, and the level of income;
- HL and eHL;
- Variables reflecting the tools used for televisits: telephone, VTC, e-mail;
- Variables reflecting the aims of televisits: symptoms suggesting COVID-19, other acute symptoms, follow-up or exacerbation of the chronic disease, ill children or other family members, renewal of prescriptions;
- The number of different types of e-health services utilized before the pandemic and the number of remote interactions with a health professional during the pandemic;
- The perception of the health risk of COVID-19 and the intention to be vaccinated when the vaccine against COVID-19 became available.
2.3. Statistical Analysis
3. Results
3.1. Characteristics of the Study Group
3.2. The Use of e-Health Solutions before and during the Pandemic
3.3. The Aims of Remote Physician’s Advice during the Pandemic
3.4. Determinants of User Satisfaction with Remote Physician’s Visits
3.5. Determinants of the Opinions about Ease-of-Use
4. Discussion
Limitations
5. Conclusions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Variable Categories | All Respondents (n = 2410) | Users of Remote Visits (n = 1389) | ||
---|---|---|---|---|---|
% | n | % | n | ||
Gender | female | 51.16 | 1233 | 55.65 | 773 |
male | 48.84 | 1177 | 44.35 | 616 | |
Place of residence | rural | 34.52 | 832 | 35.49 | 493 |
urban below 20,000 inhabitants | 9.54 | 230 | 9.94 | 138 | |
urban 20,000–100,000 inhabitants | 23.44 | 565 | 22.17 | 308 | |
urban 100,000–200,000 inhabitants | 9.46 | 228 | 10.37 | 144 | |
urban 200,000–500,000 inhabitants | 9.21 | 222 | 9.14 | 127 | |
urban above 500,000 inhabitants | 13.82 | 333 | 12.89 | 179 | |
Education | lower than secondary | 20.50 | 494 | 20.16 | 280 |
secondary | 39.50 | 952 | 38.80 | 539 | |
post-secondary non-university | 11.83 | 285 | 12.38 | 172 | |
university Bachelors | 11.78 | 284 | 11.88 | 165 | |
university Masters | 16.39 | 395 | 16.77 | 233 | |
Net monthly household income | not more than 1000 PLN | 11.74 | 283 | 11.23 | 156 |
1001–1500 PLN | 17.80 | 429 | 17.57 | 244 | |
1501–2000 PLN | 22.66 | 546 | 23.40 | 325 | |
2001–3000 PLN | 28.76 | 693 | 29.01 | 403 | |
more than 3000 PLN | 19.05 | 459 | 18.79 | 261 | |
Vocational status | employee | 49.50 | 1193 | 52.12 | 724 |
self-employed or farmer | 8.17 | 197 | 8.57 | 119 | |
retired or on disability pension | 12.41 | 299 | 12.81 | 178 | |
high school or university student | 10.91 | 263 | 7.92 | 110 | |
vocationally passive incl. unemployed | 19.00 | 458 | 18.57 | 258 | |
Marital status | married or in partnership | 67.01 | 1615 | 71.20 | 989 |
single | 21.70 | 523 | 17.64 | 245 | |
widowed | 3.82 | 92 | 3.53 | 49 | |
divorced or in separation | 7.47 | 180 | 7.63 | 106 | |
The perception of the COVID-19 health threat | decidedly no | 7.6 | 184 | 6.1 | 85 |
no | 11.0 | 264 | 10.2 | 141 | |
difficult to say | 22.2 | 534 | 22.1 | 307 | |
yes | 29.4 | 709 | 28.9 | 401 | |
decidedly yes | 29.8 | 719 | 32.8 | 455 | |
Intention to be vaccinated against COVID-19 | decidedly no | 26.5 | 638 | 24.0 | 334 |
no | 12.5 | 302 | 13.3 | 185 | |
difficult to say | 33.7 | 813 | 32.8 | 456 | |
yes | 14.1 | 340 | 15.6 | 216 | |
decidedly yes | 13.2 | 317 | 14.3 | 198 | |
Satisfaction of remote visit | satisfied | 58.94 | 811 | ||
not satisfied or difficult to say | 41.06 | 565 | |||
Ease-of-use of remote visit | easy to use | 67.73 | 934 | ||
difficult to use or difficult to say | 32.27 | 445 |
Variable | Before COVID-19 Pandemic | First 6 Months of the Pandemic | % Change in the Service Use | p * | ||
---|---|---|---|---|---|---|
n | % | n | % | % | ||
Remote visit | ||||||
irrespective of the tool | 455 | 18.88 | 1389 | 57.63 | 205.27 | <0.001 |
telephone-based | 280 | 11.62 | 1244 | 51.62 | 344.23 | <0.001 |
VTC-based | 82 | 3.40 | 124 | 5.15 | 51.47 | 0.003 |
e-mail-based | 118 | 4.90 | 189 | 7.84 | 60.00 | <0.001 |
Other e-health services | ||||||
e-booking of visits to a physician | 664 | 27.55 | 532 | 22.07 | −19.78 | <0.001 |
e-prescription | 1019 | 42.28 | 1351 # | 56.06 | 32.59 | <0.001 |
e-sick leave | 463 | 19.21 | 401 # | 16.64 | −13.38 | 0.022 |
e-referral | 289 | 11.99 | 392 # | 16.27 | 35.70 | <0.001 |
Internet patient portal | 475 | 19.71 | 398 | 16.51 | −16.24 | 0.005 |
Aim | n | % |
---|---|---|
Symptoms suggesting COVID-19 | 144 | 10.37 |
Other acute symptoms | 374 | 26.93 |
Follow-up or exacerbation of chronic disease | 298 | 21.45 |
Ill child or other family member | 339 | 24.41 |
Prescription renewal | 609 | 43.84 |
Variables | Categories | User Satisfaction | Ease-of-Use | ||
---|---|---|---|---|---|
OR (95% CI) | p | OR (95% CI) | p | ||
HL | 1.12 (1.08–1.16) | <0.001 | 1.18 (1.14–1.22) | <0.001 | |
eHL | 1.06 (1.04–1.09) | <0.001 | 1.09 (1.06–1.11) | <0.001 | |
Age | 1.02 (1.01–1.03) | <0.001 | 1.01 (1.009–1.02) | 0.017 | |
E-health services before the pandemic $ | 1.20 (1.10–1.31) | <0.001 | 1.21 (1.12–1.30) | <0.001 | |
Gender | Female # | ||||
male | 1.19 (0.96–1.47) | 0.121 | 0.98 (0.78–1.23) | 0.864 | |
Place of residence | rural # | ||||
urban below 20,000 | 0.78 (0.53–1.14) | 0.197 | 0.83 (0.56–1.24) | 0.363 | |
urban 20,000–100,000 | 0.98 (0.73–1.31) | 0.891 | 1.07 (0.78–1.45) | 0.682 | |
urban 100,000–200,000 | 0.88 (0.60–1.28) | 0.505 | 0.84 (0.57–1.25) | 0.396 | |
urban 200,000–500,000 | 0.95 (0.64–1.42) | 0.820 | 0.98 (0.65–1.49) | 0.926 | |
urban above 500,000 | 0.97 (0.69–1.38) | 0.886 | 1.15 (0.79–1.67) | 0.476 | |
Education | lower than secondary # | ||||
secondary | 0.97 (0.73–1.31) | 0.857 | 1.04 (0.77–1.42) | 0.786 | |
post-secondary non-university | 1.13 (0.77–1.67) | 0.541 | 1.05 (0.70–1.57) | 0.809 | |
university Bachelors | 1.40 (0.94–2.09) | 0.101 | 1.67 (1.08–2.58) | 0.020 | |
university Masters | 1.15 (0.81–1.65) | 0.428 | 1.31 (0.90–1.91) | 0.161 | |
Net monthly income per household member | ≤1000 PLN # | ||||
1001–1500 PLN | 1.56 (1.04–2.36) | 0.032 | 1.71 (1.13–2.61) | 0.012 | |
1501–2000 PLN | 1.27 (0.87–1.88) | 0.219 | 1.78 (1.20–2.66) | 0.004 | |
2001–3000 PLN | 1.31 (0.90–1.90) | 0.161 | 1.83 (1.24–2.68) | 0.002 | |
>3000 PLN | 1.56 (1.04–2.35) | 0.030 | 1.34 (0.89–2.01) | 0.161 | |
Vocational status | Employee # | ||||
self-employed or farmer | 0.87 (0.59–1.29) | 0.488 | 0.88 (0.57–1.34) | 0.541 | |
retired or on disability pension | 1.34 (0.94–1.90) | 0.103 | 0.89 (0.62–1.28) | 0.537 | |
high school or university student | 0.51 (0.34–0.77) | 0.001 | 0.49 (0.32–0.74) | 0.001 | |
vocationally passive incl. unemployed | 0.69 (0.52–0.92) | 0.012 | 0.53 (0.39–0.71) | <0.001 | |
Marital status | married or in partnership # | ||||
single | 0.86 (0.65–1.14) | 0.288 | 0.99 (0.73–1.34) | 0.963 | |
widowed | 0.81 (0.45–1.45) | 0.475 | 0.97 (0.53–1.80) | 0.933 | |
divorced or in separation | 1.26 (0.83–1.91) | 0.285 | 0.92 (0.60–1.40) | 0.693 | |
VTC-based RPA | No # | ||||
Yes | 1.38 (0.94–2.04) | 0.104 | 0.91 (0.62–1.35) | 0.641 | |
Telephone-based RPA | No # | ||||
Yes | 1.52 (1.07–2.16) | 0.019 | 2.58 (1.82–3.66) | <0.001 | |
E-mail-based RPA | No # | ||||
Yes | 1.14 (0.83–1.56) | 0.426 | 0.83 (0.60–1.15) | 0.263 | |
COVID-19 symptoms | No # | ||||
Yes | 0.93 (0.65–1.32) | 0.682 | 0.83 (0.58–1.18) | 0.298 | |
Other acute symptoms | No # | ||||
Yes | 1.08 (0.84–1.37) | 0.558 | 1.34 (1.03–1.75) | 0.027 | |
Follow-up or exacerbation of chronic disease | No # | ||||
Yes | 1.13 (0.87–1.47) | 0.355 | 0.80 (0.61–1.04) | 0.098 | |
Ill child or another family member | No # | ||||
Yes | 0.74 (0.57–0.94) | 0.015 | 0.93 (0.72–1.21) | 0.599 | |
Prescription renewal | No # | ||||
Yes | 1.28 (1.03–1.59) | 0.026 | 1.24 (0.99–1.56) | 0.066 | |
The perception of the COVID-19 health threat | decidedly no # | ||||
No | 1.01 (0.59–1.75) | 0.964 | 1.70 (0.97–2.97) | 0.063 | |
difficult to say | 0.78 (0.48–1.27) | 0.325 | 1.24 (0.76–2.02) | 0.393 | |
yes | 1.13 (0.70–1.82) | 0.610 | 1.62 (1.009–2.61) | 0.049 | |
decidedly yes | 1.82 (1.13–2.93) | 0.013 | 2.31 (1.43–3.74) | 0.001 | |
Intention to vaccinate against COVID-19 | decidedly no # | ||||
No | 1.11 (0.77–1.59) | 0.582 | 0.77 (0.53–1.13) | 0.186 | |
difficult to say | 1.38 (1.04–1.84) | 0.027 | 1.05 (0.77–1.42) | 0.760 | |
Yes | 1.35 (0.95–1.91) | 0.094 | 0.93 (0.65–1.34) | 0.704 | |
decidedly yes | 1.89 (1.31–2.74) | 0.001 | 1.12 (0.76–1.64) | 0.575 | |
Number of episodes * | 1 # | ||||
2–3 | 0.80 (0.59–1.07) | 0.124 | 0.88 (0.65–1.19) | 0.402 | |
4–5 | 1.03 (0.72–1.47) | 0.859 | 1.18 (0.81–1.71) | 0.388 | |
>5 | 0.85 (0.57–1.27) | 0.430 | 1.09 (0.71–1.68) | 0.682 |
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Duplaga, M. A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits. Int. J. Environ. Res. Public Health 2022, 19, 8338. https://doi.org/10.3390/ijerph19148338
Duplaga M. A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits. International Journal of Environmental Research and Public Health. 2022; 19(14):8338. https://doi.org/10.3390/ijerph19148338
Chicago/Turabian StyleDuplaga, Mariusz. 2022. "A Nationwide Natural Experiment of e-Health Implementation during the COVID-19 Pandemic in Poland: User Satisfaction and the Ease-of-Use of Remote Physician’s Visits" International Journal of Environmental Research and Public Health 19, no. 14: 8338. https://doi.org/10.3390/ijerph19148338