Willingness to Use and Pay for Telemedicine and Teleconsultation Across Five Clinical Domains in South Korea: Cross-Sectional Survey

Abstract

Background: The COVID-19 pandemic accelerated global telehealth adoption, prompting the South Korean government to temporarily legalize telemedicine in 2020 and subsequently launch a pilot program in 2023. As South Korea transitions to a postpandemic digital health environment, understanding the factors associated with willingness to use (WTU) and willingness to pay (WTP) for telemedicine and teleconsultation is essential for informing effective policy and service design. However, few studies have explored how preferences vary across clinical domains or user groups. Objective: This study examined the factors that influence WTU and WTP for telemedicine and teleconsultation across 5 clinical domains: dermatological, psychiatric, musculoskeletal, internal medicine, and cancer disorders. Methods: A cross-sectional survey was conducted among 552 participants aged 19-69 years in South Korea, selected through stratified sampling. Multiple logistic regression analysis was used to examine WTU and WTP, considering sociodemographic factors and previous telemedicine experience. Results: Participants' age, residence, and previoustelemedicineexperience significantly influencedtheir WTU and WTP for telemedicine services. WTP increased with age for both telemedicine (P-for-trend=.02) and teleconsultation (P-for-trend=.001). Noncapital residents showed significantly higher WTU for teleconsultation than capital area residents (odds ratio [OR] 1.48, 90% CI 1.03-2.12; P=.07). Participants with previous telemedicine experience showed higher WTU for telemedicine (OR 4.07, 90% CI 1.84-9.04; P=.004) and teleconsultation (OR 2.21, 90% CI 1.21-4.06; P=.03), and higher WTP for telemedicine(OR 2.89, 90% CI 1.84-4.54; P<.001) and teleconsultation (OR 2.76, 90% CI 1.77-4.30; P<.001). WTU and WTP varied by clinical domain: psychiatric care showed the highest WTU (64.5%) and WTP (27.0%) fortelemedicine, while cancer disorders showed higher WTU (48.6%) and WTP (24.8%) for teleconsultationthan for telemedicine. Conclusions:WTU and WTP for telemedicine and teleconsultation differ substantially depending on service type, clinical domain, and user characteristics. These findings highlight the importance of considering prior telemedicine experience, regional access disparities, and condition-specific care needs when designing digital health strategies. Accordingly, flexible, user-centered telehealth policies are needed to support service accessibility and equitable implementation in the post-COVID-19 era. The insights from this study can serve as a practical foundation for developing inclusive digital health systems in countries undergoing similar transitions.