Virtual Physical Therapy Use, Satisfaction Lower Than In-Person

A recent study published in the Orthopaedic Journal of Sports Medicine found that despite the benefits associated with telehealth use, virtual physical therapy (PT) patients were less satisfied with treatment than those who received care in person.

Like most other specialties, PT experienced a high uptake in telehealth use among patients because of COVID-19 pandemic restrictions on in-person care. Researchers aimed to determine how it compared to in-person services in terms of patient access and satisfaction once in-person care became available again.

A significant driver for this study was the return to in-person care following the drop in COVID-19 cases after the initial surge in 2020. Data collected from the study may hold the potential to assist physical therapists in determining how best to provide care, researchers stated.

The study focused on evaluating utilization trends and patient satisfaction with virtual PT. In doing so, researchers reviewed data from 59,461 in-person and 2,016 telehealth visits from a single physical rehabilitation center. All visits occurred between March 2020 and December 2021. In April 2020, physical therapists were advised to work from home, and the center officially reopened in September 2020 with social distancing guidelines in place.

Data from 1,012 patient satisfaction surveys were also collected for analysis.

After reviewing the information, researchers noted that telehealth PT patients were often older, female, White, spoke English as a first language, and were Medicare beneficiaries.

Compared to the average age of in-person visitors, those who used telehealth were, on average, 5 years older — 47 years old compared to 42 years old. Telehealth users and in-person users were 60.6 and 54.8 percent female, respectively. In addition, 69.7 percent of telehealth users were White, higher than 66.6 percent of in-person users who were White.

The proportion of telehealth users who spoke English as a first language was 99.2 percent, higher than 98.1 percent of those who used in-person services. Further, the share of telehealth patients who were insured through Medicare was 20.3 percent, higher than the 16.1 percent of users of in-person services covered by the same insurance.

Researchers also found that patients who participated in telehealth PT tended to live in out-of-county and small-town areas rather than in urban communities.

Also, according to the patient satisfaction survey, telehealth patients were less likely to recommend PT visits compared to in-person patients, at 75 and 89.1 percent, respectively. The survey shows that telehealth patients' overall assessment of their visits was lower compared with the in-person group.

Additionally, between 2020 and 2021, the share of virtual PT dropped from 6.9 percent to 0.9 percent.

Based on this data and the survey results, researchers concluded that telehealth might not be ideal for providing PT treatment. However, this does not necessarily diminish the benefits of telehealth for patients with limited time or access, they noted.

Though telehealth has been largely viewed as beneficial, some types of virtual care can result in low levels of patient satisfaction.

A study published in JAMA Network Open in December 2021 found that using telehealth for kidney disease management led to low patient satisfaction. In interviews, patients said they were concerned that telehealth was associated with lower visit quality and resulted in inaccurate diagnoses.