Awareness and Use of Virtual Clinics following the COVID-19 Pandemic in Saudi Arabia
Abstract
:1. Introduction
2. Study Theoretical Model
3. Material and Methods
3.1. Study Design and Population
3.2. Survey Instrument
3.3. Instrument Validation
3.4. Statistical Analysis
4. Results
4.1. Descriptive Statistics (Univariate Analysis)
4.2. Virtual Clinic Users
4.3. Bivariate Analysis
4.4. Interpretation of Multivariable Analysis
5. Discussion
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Rutherford, E.; Noray, R.; Hearráin, C.; Quinlan, K.; Hegarty, A.; Ekpotu, L.; Arize, C.; Fabamwo, F.; Alrubaiaan, A.; Bhupalan, A.; et al. Potential Benefits and Drawbacks of Virtual Clinics in General Surgery: Pilot Cross-Sectional Questionnaire Study. JMIR Perioper. Med. 2020, 3, e12491. [Google Scholar] [CrossRef]
- Wong, A.; Bhyat, R.; Srivastava, S.; Lomax, L.B.; Appireddy, R. Patient Care During the COVID-19 Pandemic: Use of Virtual Care. J. Med Internet Res. 2021, 23, e20621. [Google Scholar] [CrossRef]
- Santoro, S.L.; Donelan, K.; Haugen, K.; Oreskovic, N.M.; Torres, A.; Skotko, B.G. Transition to virtual clinic: Experience in a multidisciplinary clinic for Down syndrome. Am. J. Med Genet. Part C Semin. Med Genet. 2021, 187, 70–82. [Google Scholar] [CrossRef]
- MOH. MOH News—MOH Continues Expanding Virtual Clinic Service. 2021. Available online: https://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2021-06-20-009.aspx (accessed on 6 November 2021).
- Aldosari, M.N.; Alharbi, K.G.; Alhassan, A.M.; Alshallal, K.A.; Altamimi, A.M.; Altulaihi, B.A. Patient satisfaction with virtual clinic during Coronavirus disease (COVID-19) pandemic in primary healthcare, Riyadh, Saudi Arabia. J. Fam. Community Med. 2021, 28, 48–54. [Google Scholar] [CrossRef]
- McGrail, K.M.; Ahuja, M.A.; Leaver, C.A. Virtual Visits and Patient-Centered Care: Results of a Patient Survey and Observational Study. J. Med Internet Res. 2017, 19, e177. [Google Scholar] [CrossRef]
- Polinski, J.M.; Barker, T.; Gagliano, N.; Sussman, A.J.; Brennan, T.A.; Shrank, W.H. Patients’ Satisfaction with and Preference for Telehealth Visits. J. Gen. Intern. Med. 2016, 31, 269–275. [Google Scholar] [CrossRef]
- Alwabili, A.A.; Alotaibi, E.A.; AlE’ed, A.A.; Alqunibut, I.; Alotaibi, O.A. Measurement of Patient Satisfaction With the Trend of Virtual Clinics During the COVID-19 Pandemic. Cureus 2021, 13, e16016. [Google Scholar] [CrossRef]
- Hassounah, M.; Raheel, H.; Alhefzi, M. Digital Response During the COVID-19 Pandemic in Saudi Arabia. J. Med Internet Res. 2020, 22, e19338. [Google Scholar] [CrossRef]
- Al-Hazmi, A.M.; Sheerah, H.A.; Arafa, A. Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do? Int. J. Environ. Res. Public Heal. 2021, 18, 10617. [Google Scholar] [CrossRef]
- Ministry of Health, Digital Health Center of Excellence. 2022. Available online: https://www.moh.gov.sa/en/Ministry/Projects/Digital-Health-Center-of-Excellence/Pages/Programs.aspx (accessed on 9 September 2022).
- Rosenstock, I.M. The Health Belief Model and Preventive Health Behavior. Health Educ. Behavior. 1974, 2, 354–386. [Google Scholar] [CrossRef]
- Bandura, A. Social Cognitive Theory: An Agentic Perspective. Annu. Rev. Psychol. 2001, 52, 1–26. [Google Scholar] [CrossRef]
- Ajzen, I.; Fishbein, M. Understanding Attitudes and Predicting Social Behavior/Icek Ajzen, Martin Fishbein; Prentice-Hall: Englewood Cliffs, NJ, USA, 1980. [Google Scholar]
- Ajzen, I. The Theory of Planned Behavior. Organ. Behav. Hum. Decis. Process. 1991, 50, 179–211. [Google Scholar] [CrossRef]
- Rahimi, B.; Nadri, H.; Afshar, H.L.; Timpka, T. A Systematic Review of the Technology Acceptance Model in Health Informatics. Appl. Clin. Inform. 2018, 9, 604–634. [Google Scholar] [CrossRef] [PubMed]
- Klaic, M.; Galea, M.P. Using the Technology Acceptance Model to Identify Factors That Predict Likelihood to Adopt Tele-Neurorehabilitation. Front. Neurol. 2020, 11, 580832. [Google Scholar] [CrossRef] [PubMed]
- Kamal, S.A.; Shafiq, M.; Kakria, P. Investigating acceptance of telemedicine services through an extended technology acceptance model (TAM). Technol. Soc. 2020, 60, 101212. [Google Scholar] [CrossRef]
- Al-Rayes, S.A.; Alumran, A.; AlFayez, W. The Adoption of the Electronic Health Record by Physicians. Methods Inf. Med. 2019, 58, 63–70. [Google Scholar] [CrossRef] [PubMed]
- Alumran, A.; Alkhaldi, O.; Aldroorah, Z.; Alsayegh, Z.; Alsafwani, F.; Almaghraby, N. Utilization of an Electronic Triage System by Emergency Department Nurses. J. Multidiscip. Heal. 2020, 13, 339–344. [Google Scholar] [CrossRef]
- Almegbel, H.; Aloud, M. Factors Influencing the Adoption of mHealth Services in Saudi Arabia: A Patient-centered Study. Int. J. Comput. Sci. Netw. Secur. 2021, 21, 313–324. [Google Scholar]
- Wu, D.; Gu, H.; Gu, S.; You, H. Individual motivation and social influence: A study of telemedicine adoption in China based on social cognitive theory. Heal. Policy Technol. 2021, 10, 100525. [Google Scholar] [CrossRef]
- Darrat, I.; Tam, S.; Boulis, M.; Williams, A.M. Socioeconomic Disparities in Patient Use of Telehealth During the Coronavirus Disease 2019 Surge. JAMA Otolaryngol. Neck Surg. 2021, 147, 287–295. [Google Scholar] [CrossRef]
- Nguyen, O.T.; Watson, A.K.; Motwani, K.; Warpinski, C.; McDilda, K.; Leon, C.; Khanna, N.; Nall, R.W.; Turner, K. Patient-Level Factors Associated with Utilization of Telemedicine Services from a Free Clinic During COVID-19. Telemed. e-Health 2022, 28, 526–534. [Google Scholar] [CrossRef] [PubMed]
- Luo, J.; Tong, L.; Crotty, B.H.; Somai, M.; Taylor, B.; Osinski, K.; George, B. Telemedicine Adoption during the COVID-19 Pandemic: Gaps and Inequalities. Appl. Clin. Inform. 2021, 12, 836–844. [Google Scholar] [CrossRef] [PubMed]
- Taherdoost, H. Sampling Methods in Research Methodology; How to Choose a Sampling Technique for Research. SSRN Electron. J. 2018, 5, 18–27. [Google Scholar] [CrossRef]
- Chuttur, M. Overview of the Technology Acceptance Model: Origins, Developments and Future Directions. Sprouts Work Pap. Inf. Syst. 2009, 9. Available online: https://www.researchgate.net/publication/277766395 (accessed on 1 February 2022).
- Cimperman, M.; Brenčič, M.M.; Trkman, P. Analyzing older users’ home telehealth services acceptance behavior—applying an Extended UTAUT model. Int. J. Med. Inform. 2016, 90, 22–31. [Google Scholar] [CrossRef]
- Huang, J.-C. Innovative health care delivery system—A questionnaire survey to evaluate the influence of behavioral factors on individuals’ acceptance of telecare. Comput. Biol. Med. 2013, 43, 281–286. [Google Scholar] [CrossRef] [PubMed]
- Tsang, S.; Royse, C.F.; Terkawi, A.S. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J. Anaesth. 2017, 11, S80–S89. [Google Scholar] [CrossRef] [PubMed]
- Taber, K.S. The Use of Cronbach’s Alpha When Developing and Reporting Research Instruments in Science Education. Res. Sci. Educ. 2017, 48, 1273–1296. [Google Scholar] [CrossRef]
- Mishra, P.; Pandey, C.M.; Singh, U.; Gupta, A.; Sahu, C.; Keshri, A. Descriptive statistics and normality tests for sta-tistical data. Ann. Card. Anaesth. 2019, 22, 67–72. [Google Scholar] [CrossRef] [PubMed]
- IBM Corp. IBM SPSS Statistics for Windows, Version 26.0; IBM Corp: Armonk, NY, USA, 2019. [Google Scholar]
- Lott, A.; Campbell, K.A.; Hutzler, L.; Lajam, C.M. Telemedicine Utilization at an Academic Medical Center During COVID-19 Pandemic: Are Some Patients Being Left Behind? Telemed. e-Health 2022, 28, 44–50. [Google Scholar] [CrossRef]
- Mohammed, H.T.; Hyseni, L.; Bui, V.; Gerritsen, B.; Fuller, K.; Sung, J.; Alarakhia, M. Exploring the use and challenges of implementing virtual visits during COVID-19 in primary care and lessons for sustained use. PLoS ONE 2021, 16, e0253665. [Google Scholar] [CrossRef] [PubMed]
- Kruse, C.S.; Karem, P.; Shifflett, K.; Vegi, L.; Ravi, K.; Brooks, M. Evaluating barriers to adopting telemedicine worldwide: A systematic review. J. Telemed. Telecare 2018, 24, 4–12. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Perry, A.F.; Frederico, F.; Huebner, J. Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care; IHI White Paper; Institute for Healthcare Improvement: Boston, MA, USA, 2021. [Google Scholar]
Variables | N (%) | |
---|---|---|
Awareness of virtual clinics (n = 405) | Aware | 286 (70.6) |
Not aware | 119 (29.4) | |
Users of virtual clinics (n = 286) | Yes | 99 (34.6) |
No | 187 (65.3) | |
Sample Characteristics (n = 405) | N (%) | |
Gender | Male | 106 (26.2) |
Female | 299 (73.8) | |
Nationality | Saudi | 388 (95.8) |
Non-Saudi | 17 (4.2) | |
Age (in years) | 18–30 | 287 (70.9) |
31–40 | 51 (12.6) | |
41–50 | 30 (7.4) | |
50+ | 37 (9.1) | |
Marital status | Single | 280 (69.1) |
Married | 125 (30.9) | |
Residential region | Eastern | 293 (72.3) |
Central | 45 (11.1) | |
Western | 38 (9.4) | |
Northern | 5 (1.2) | |
Southern | 24 (5.9) | |
Education level | Highschool or less | 128 (31.6) |
Diploma | 27 (6.7) | |
Bachelor | 192 (47.4) | |
Postgraduate | 58 (14.3) | |
Employment status | Employed | 137 (33.8) |
Unemployed | 249 (61.5) | |
Retired | 19 (4.7) | |
Monthly income | ≤2801.12 USD | 239 (59.0) |
2801.68–5602.24 USD | 44 (10.9) | |
5602.80–8403.36 USD | 43 (10.6) | |
8403.92–11,204.48 USD | 42 (10.4) | |
>11,204.48 USD | 37 (9.1) | |
Existence of chronic disease | Yes | 57 (14.1) |
None | 348 (85.9) |
Questions | N (%) | |
---|---|---|
How many times did you use the virtual clinic? | Once | 24 (24.2) |
Twice | 26 (26.3) | |
More than 2 times | 49 (49.5) | |
In your last visit to the virtual clinic: | ||
What was the type of your visit? | Initial consultation | 54 (54.5) |
Follow up | 45 (45.5) | |
Who was the visit for? | Self | 72 (72.7) |
Else | 27 (27.3) | |
What was the clinic type? | Family medicine | 55 (55.6) |
Internal medicine | 4 (4) | |
Pediatric | 8 (8.1) | |
Obstetrics and gynecology | 3 (3) | |
Ophthalmology | 1 (1) | |
Dermatology | 6 (6.1) | |
Ear, nose, and throat | 6 (6.1) | |
Psychiatry | 8 (8.1) | |
Neurology | 1 (1) | |
Urology | 2 (2) | |
Dentistry | 3 (3) | |
Other | 2 (2) | |
What was the type of the healthcare facility? | Private | 23 (23.2) |
Governmental | 76 (76.8) | |
What was the mode of communication? | Voice call | 83 (83.8) |
Video call | 16 (16.2) | |
What type of device did you use? | Cell phone | 93 (94) |
Tablet device | 3 (3) | |
Laptop | 3 (3) |
Variable | Have You Ever Used Virtual Clinics? | p-Value | |
---|---|---|---|
Yes (n = 99) N (%) | No (n = 187) N (%) | ||
Gender | (0.014) a | ||
Male | 30 (30.3) | 33 (17.6) | |
Female | 69 (69.7) | 154 (82.4) | |
Nationality | (0.935) b | ||
Saudi | 96 (97.0) | 181 (96.8) | |
Non-Saudi | 3 (3.0) | 6 (3.2) | |
Age | (0.010) a | ||
18–30 | 58 (58.6) | 143 (76.5) | |
31–40 | 22 (22.2) | 21 (11.2) | |
41–50 | 12 (12.1) | 11 (5.9) | |
>50 | 7 (7.1) | 12 (6.4) | |
Marital status | (0.001) a | ||
Single | 56 (56.6) | 141 (75.4) | |
Married | 43 (43.4) | 46 (24.6) | |
Education level | (0.006) a | ||
High school or less | 21(21.2) | 68 (36.4) | |
Diploma | 7 (7.1) | 13 (7) | |
Bachelor | 44 (44.4) | 82 (43.9) | |
Postgraduate | 27 (27.3) | 24 (12.8) | |
Employment status | (0.003) b | ||
Employed | 48 (48.5) | 54 (28.9) | |
Unemployed | 46 (46.5) | 128 (68.4) | |
Retired | 5 (5.1) | 5 (2.7) | |
Monthly income | (0.014) a | ||
≥2801.12 USD | 49 (49.5) | 118 (63.1) | |
2801.68–5602.24 USD | 9 (9.1) | 19 (10.2) | |
5602.80–8403.36 USD | 10 (10.1) | 21 (11.2) | |
8403.92–11,204.48 USD | 20 (20.2) | 13 (7) | |
<11,204.48 USD | 11 (11.1) | 16 (8.6) | |
Have a chronic disease | (0.117) a | ||
Yes | 19 (19.2) | 23 (12.3) | |
No | 80 (80.8) | 164 (87.7) |
Variable | Have You Ever Used Virtual Clinics? Mean (SD) | Mean Difference (95% CI) | t-Test (p-Value) | |
---|---|---|---|---|
Yes (n = 99) N (%) | No (n = 187) N (%) | |||
Perceived Usefulness | 17.77 (2.42) | 16.98 (2.51) | 0.79 (0.18, 1.40) | 2.558 (0.011) |
Perceived Ease of Use | 17.65 (2.30) | 15.38 (2.96) | 2.27 (1.59, 2.94) | 6.627 (<0.001) |
Social Influence | 15.65 (3.69) | 14.11 (3.12) | 1.53 (0.72, 2.35) | 3.707 (<0.001) |
Model | Independent Variables | Standardized Beta Coefficients | p-Value | R2 |
---|---|---|---|---|
1 | PU | −0.150 * | 0.048 | 0.204 |
PEU | 0.401 ** | 0.000 | ||
2 | PU | −0.165 * | 0.035 | 0.208 |
PEU | 0.304 ** | 0.000 | ||
SI | 0.042 | 0.351 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Al-Rayes, S.; Alumran, A.; Aljanoubi, H.; Alkaltham, A.; Alghamdi, M.; Aljabri, D. Awareness and Use of Virtual Clinics following the COVID-19 Pandemic in Saudi Arabia. Healthcare 2022, 10, 1893. https://doi.org/10.3390/healthcare10101893
Al-Rayes S, Alumran A, Aljanoubi H, Alkaltham A, Alghamdi M, Aljabri D. Awareness and Use of Virtual Clinics following the COVID-19 Pandemic in Saudi Arabia. Healthcare. 2022; 10(10):1893. https://doi.org/10.3390/healthcare10101893
Chicago/Turabian StyleAl-Rayes, Saja, Arwa Alumran, Haifa Aljanoubi, Aram Alkaltham, Manar Alghamdi, and Duaa Aljabri. 2022. "Awareness and Use of Virtual Clinics following the COVID-19 Pandemic in Saudi Arabia" Healthcare 10, no. 10: 1893. https://doi.org/10.3390/healthcare10101893