Patient Satisfaction for Telehealth Physical Therapy Services was Comparable to that of In-Person Services during the COVID-19 Pandemic

Abstract

Background The COVID-19 pandemic has transformed the practice of physical therapy (PT), from a model based on in-person delivery to one that includes telehealth. However, research is needed to assess value, patient satisfaction, and clinical outcomes in the delivery of telehealth PT. Purposes We sought to compare patient satisfaction with in-person and telehealth PT and to determine the factors—such as age, gender, or insurance payer—that contributed to patient satisfaction scores. Methods Patients between the ages of 18 and 90 years who received outpatient PT at our institution were texted a patient satisfaction survey. Surveys were sent to patients who received in-person PT from January 1 to May 8, 2020, and to patients who received telehealth PT from April 21 to May 8, 2020. Patients' age, gender, insurance payer, and written comments were also collected. Kruskal-Wallis tests were used to compare survey scores between groups. χ-squared tests were used to compare categorical patient characteristics between groups. Results In total, 12,345 surveys were sent out. We included completed surveys from 1147 patients in the analysis. Of these, 33% identified as male and 67% as female, mean age was 60.3 years, 58% had commercial insurance, 36% had Medicare, 3% had Medicaid, 2% had no-fault/worker's compensation, and 1% had international insurance. The question of satisfaction was answered by 1074 patients. No statistical difference in satisfaction was seen in age or gender groups. Satisfaction differed by insurance type, but when analysis excluded patients with international insurance, there was no difference between groups. In-person PT patients reported higher satisfaction in achieving treatment goals, as rated on a 1-to-5 scale (4.7 ± 0.6), than telehealth PT patients (4.6 ± 0.6), although it is unclear if this result is clinically meaningful. There was no significant difference in the remaining follow-up questions. Conclusion We found no overall difference in patient satisfaction between those receiving in-person PT and those receiving telehealth PT. This was true for initial and follow-up visits, with the exception of two categories: the “ability of scheduling an appointment” and “progress towards attaining your treatment goals.” However, the clinical significance of these two exceptions is questionable. Ongoing research is indicated to evaluate the efficacy of telehealth PT while identifying the best patients and conditions for use during non-crisis times. Future studies should determine the effect of telehealth PT on patient-reported outcome measures, function, and value.

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“…Ratings of participant and/or clinician experience and satisfaction with telehealth physiotherapy assessments during the COVID-19 pandemic were reported in three of the included utility studies in this review [ 49 , 62 , 64 ]. These papers reported overall good levels of satisfaction with telehealth assessments, one reporting no statistically significant difference in satisfaction levels between face-to-face, telehealth or combined types of services and a higher satisfaction level for participants in the telehealth group for appointment scheduling ( P < 0.001) [ 49 ].…”

A Proposal for the Study of a Conceptual Framework to Inform Optimal Use of Telehealth for Postoperative Upper Extremity Care

“…scored on a 0 to 10 scale with 10 being "most likely" and 0 as "not likely at all." Previous analysis by Eannucci et al [7] found the difference between in-person and telemedicine responses to this question to be approximately 0.10 with standard deviation of 1.2. For our study population, we more conservatively estimated a difference of 0.20 with a standard deviation of 1.5.…”

“…To calculate sample size, we used patient satisfaction scores as a primary outcome for the study. Patient satisfaction was operationalized with the question, “How likely is it that you would recommend HSS to friends and family?” scored on a 0 to 10 scale with 10 being “most likely” and 0 as “not likely at all.” Previous analysis by Eannucci et al [7] found the difference between in-person and telemedicine responses to this question to be approximately 0.10 with standard deviation of 1.2. For our study population, we more conservatively estimated a difference of 0.20 with a standard deviation of 1.5.…”