Telemedicine Patient Satisfaction Across Nine Countries: A Cross-Sectional Comparative Study

Background/Objectives: This study examined telemedicine patient satisfaction as a multidimensional construct. In addition to overall satisfaction, four satisfaction dimensions were examined (health benefits, patient-centered care, financial costs, and non-financial costs). The aim of this study was to determine if overall satisfaction and the predictive capacity of the defined satisfaction dimensions varied across the nine countries studied. Methods: Subjects were telemedicine patients from Australia, Brazil, Canada, Germany, India, Japan, Mexico, the United Kingdom, and the United States. A questionnaire using Likert scale items measured the patient satisfaction variables. Telemedicine patient overall satisfaction was the dependent variable, and the four dimensions of satisfaction were the independent variables. ANOVA tested for differences in patient overall satisfaction. Regression analysis examined the significance of the four satisfaction dimensions as predictors of overall satisfaction. Random forest machine learning assessed which dimension in each country was the best predictor of overall satisfaction. Results: Telemedicine patient satisfaction was found to differ across countries. Patients in India and Brazil had the highest mean overall satisfaction, whereas patients in Japan had the lowest. Patient-centered care was the most important predictor of overall satisfaction in all countries except the United States and Japan, where the greatest predictor was telemedicine non-financial costs. Conclusions: Telemedicine patient satisfaction differences were observed across the countries studied. Telemedicine service providers may need to adapt their service offerings to align with local patient expectations and norms to maximize satisfaction. A multidimensional examination of telemedicine patient satisfaction may be able to provide potential insights into target areas for service improvements.