Impact of the cost-of-living crisis on patient preferences towards virtual consultations

Since 2021, the world has faced a cost-of-living crisis that has adversely affected population health. With rising living costs, many people have been forced to make significant cuts in their daily expenses and adjust their lifestyles accordingly. But has this crisis influenced how people prefer to access health services? In this blog, we share the results of our international cross-sectional study involving 6,391 participants from the United Kingdom, Germany, Sweden, and Italy.

The COVID-19 pandemic, followed by military destabilisation in Europe, has contributed to a major cost-of-living crisis characterised by significant price and tax rises, drastic cuts to social security, as well as rises in rent and energy bills. Many people are opting for less expensive supermarkets, reducing recreational overseas travel, and cutting back on spending for clothes and leisure activities.

More people started using public transport instead of driving a car and eliminated non-essential journeys due to substantial increases in fuel prices. We believe that, in light of these forced adjustments, people’s decisions regarding healthcare might have also changed”.

Dr Tetiana Lunova, Research Associate

Since the start of the COVID-19 pandemic, virtual consultations have become widely used and remain popular even after the pandemic. Virtual consultations have proven to be a convenient alternative for many service users as they allow people to avoid travel and parking expenses, taking time off work, or securing childcare.

We hypothesise that this could have influenced patients’ decisions when choosing the modality of consultation in the cost-of-living crisis times. However, no actual research has been done in this matter so far.

Virtual consultations are getting popular but not among all population groups

We conducted a cross-sectional study using an online questionnaire survey of 6,391 participants from the UK, 1459 (23.0%), Germany, 1597 (25.0%), Italy, 1723 (27.0%) and Sweden, 1612 (25.0%). In this survey, we asked people about their preferences for the modality of care (face-to-face or virtual) before and after the onset of the cost-of-living crisis.

Overall, there has been a tangible increase in public preference for virtual care compared to pre-crisis times in all four included countries. At the same time, face-to-face appointments remain the most preferred mode of healthcare delivery.

Before the onset of the crisis, those who preferred virtual care were mainly younger and from urban backgrounds. Approximately 17% of study participants changed their preference for the modality of care after the onset of the cost-of-living crisis. Among them, younger people were more likely to switch to virtual care, while change to face-to-face was associated with younger age and lower income. Older adults were less likely to change their preference for either of the modalities.

Policy implications and lessons for future

Our findings show a growing demand for virtual consultations, particularly among younger people. However, this trend is not reflected among those who consume the most healthcare resources (i.e. older people and those from lower-income groups).

“Scaling up digital healthcare will, therefore, prove a challenging equilibrium to strike to ensure that the wants and needs of the younger population are met while not alienating the older population and those more deprived of their healthcare providers.

Dr Ana Luisa Neves, Senior Clinical Lecturer in Digital Health

Policymakers should consider strategies to ensure equitable access to virtual care at all stages of its conception and implementation. Such strategies could include digital health literacy training, creating comprehensible guidance materials, and community support initiatives. Our results also indicate that participants from rural communities preferred face-to-face appointments rather than virtual consultations.

While our study did not explore the rationale for this, future work may have implications for the industry to ensure equitable coverage of internet networks and digital health hubs to improve access to virtual services for rural communities. But, most importantly, the rationale behind patients’ preferences should be investigated to ensure all patients can access care in their preferred modality.