Understanding trust in mandatory telemedicine use during COVID-19: a modified health belief model approach

This study explores the determinants of trust in telemedicine when its use was mandated during the COVID-19 pandemic in South Korea. It extends the health belief model by incorporating two service related constructs: service quality and perceived cost.

An online survey was conducted with 288 individuals who were confirmed COVID-19 patients and required to use telemedicine services during isolation. Partial least squares structural equation modeling was applied to examine the relationships between health beliefs including perceived severity, perceived susceptibility and self-efficacy, service perceptions such as service quality and perceived cost, trust in telemedicine and behavioral intention to use telemedicine services.

The results showed that self-efficacy, service quality and perceived cost positively influenced trust in telemedicine. In contrast, perceived severity and perceived susceptibility did not have a meaningful impact. Trust was found to be a key factor in shaping patients' intention to continue using telemedicine services. Overall, the proposed model was supported, highlighting the importance of confidence and service related perceptions in building trust under mandatory usage conditions.

This study provides empirical evidence on trust formation under mandatory telemedicine use, a scenario rarely explored in the literature. It demonstrates that trust is primarily driven by users' self-efficacy and service perceptions rather than by health risk perceptions, offering practical guidance for enhancing remote care engagement during policy enforced use conditions.