Conjoint Analysis of Telemedicine Preferences for Hypertension Management Among Adult Patients

Background:Telemedicine has been differentially utilized by different demographic groups during COVID-19, exacerbating inequities in health care. We conducted conjoint and latent class analyses to understand factors that shape patient preferences for hypertension management telemedicine appointments. Methods:We surveyed 320 adults, oversampling participants from households that earned <$50K per year (77.2%) and speak a language other than English at home (68.8%). We asked them to choose among 2 hypothetical appointments through 12 conjoint tasks measuring 6 attributes. Individual utilities for attributes were constructed using logit estimation, and latent classes were identified and compared by demographic and clinical characteristics. Results:Respondents preferred in-person visits (0.353, standard error [SE]=0.039) and video appointments conducted through a secure patient portal (0.002, SE=0.040). Respondents also preferred seeing a clinician with whom they have an established relationship (0.168, SE=0.021). We found four latent classes: '' in-person '' (26.5% of participants) who strongly weighted in-person appointments, '' cost conscious '' (8.1%) who prioritized the lowest copay ($0 to $10), '' expedited '' (19.7%) who prioritized getting the earliest appointment possible (same/next day or at least within the next week), and '' comprehensive '' (45.6%) who had preferences for in-person care and telemedicine appointments through a secure portal, low copayments, and the ability to see a familiar clinician. Conclusions:Appointment preferences for hypertension management can be segmented into four groups that prioritize (1) in-person care, (2) low copayments, (3) expedited care, and (4) balanced preferences for in-person and telemedicine appointments. Evidence is needed to clarify whether aligning appointment offerings with patients ' preferences can improve care quality, equity, and efficiency.