User Satisfaction and Challenges in Telemedicine Services during the COVID-19 Pandemic in Indonesia: A Population-Based Analysis
DOI:
https://doi.org/10.26911/thejhpm.2024.09.02.09Abstract
Background: The COVID-19 pandemic has led to a surge in telemedicine utilization in Indonesia, necessitating increased attention toward user satisfaction and encountering obstacles in telemedicine services. This study aims to analyze the satisfaction and barriers faced by users of telemedicine applications, considering population characteristics during the COVID-19 pandemic in Indonesia.
Subjects and Method: Using a descriptive observational design with a cross-sectional approach, the study encompassed the entire population of telemedicine users during the COVID-19 pandemic, with samples adhering to predetermined inclusion and exclusion criteria. Data were collected through Google Forms questionnaires from August 2020 to November 2020. Subsequently, data were subjected to chi-square tests (alternative: Kruskal-Wallis) and logistic regression analyses, with p-value<0.05 and 95% confidence interval. User satisfaction with telemedicine was associated with factors such as domicile, settlement, provider, health insurance, and utilized internet network (p<0.05).
Results: User satisfaction with telemedicine was associated with factors such as domicile, settlement, provider, health insurance, and utilized internet network (p<0.05). Conversely, barriers encountered in telemedicine exhibited associations with gender, marital status, age, regional origin, residence, education, occupation, health insurance, income, provider type, internet network, and internet quota (p<0.05). A significant correlation was observed between barriers and user satisfaction with telemedicine (p<0.001). The most influential factor affecting satisfaction was income less than Rp 1,500,000 per month (OR 30.818; 95% CI: 1.751-542.394), while pay ranging from Rp 3,500,000 to 5,500,000 per month exhibited the most substantial impact on barriers (OR 5.266; 95% CI: 2.326-11.920).
Conclusion: Most respondents expressed satisfaction and encountered no obstacles when employing telemedicine. Respondents suggested enhancing telemedicine usage by emphasizing the importance of diagnostic accuracy, simplifying processes, maintaining confidentiality, optimizing application features, and improving network speed.
References
Acharya, R and Rai, J (2016). Evaluation of patient and doctor perception toward the use of telemedicine in Apollo Tele Health Services, India, Journal Familiy Medicine and Primary Care, 5(4), p. 798. doi: 10.4103/22494863.201174
Aliansi Telemedik Indonesia (2020) Members, Aliansi Telemedik Indonesia, Jakarta. Available at: https://atensi.or.id/#members. (Accessed: 7 July 2020).
Almathami HKY, Than Win K, VlahuGjorgievska E (2020). Barriers and facilitators that influence teleme-dicine-based, real-time, online consultation at patients’. homes: Systematic literature review’, Journal of Medical Internet Research, 22(2). Available at: https://doi.org/10.2-196-/16407.
Ariansyah K (2017). Faktor-Faktor yang Memengaruhi Kepuasan Pelanggan terhadap Layanan Pitalebar Berge-rak, Buletin Pos dan Teleko-munikasi, 15(1), p. 27. Available at: https://doi.o-rg/10.17933/bpostel.2017.150103.
Ariyanti S, Kautsarina K (2017). Kajian Tekno-Ekonomi pada Telehealth di Indonesia [Techno-Economic Study on Telehealth in Indonesia. Buletin Pos dan Telekomunikasi, 15(1): 43–54.
Aulia MF, Budinuryanto DC, Wismandanu O (2021). Persepsi Dokter Hewan Praktisi Hewan Kecil terhadap Telemedicine di Masa Pandemi Covid-19, Acta Veterinaria Indonesi-ana, 9(2), pp. 82–86. DOI: https://doi.org/10.29244/avi.9.2.82-86
Bakken S, Grullon-Figueroa L, Izquierdo R, Lee NJ, Morin P, Palmas W, Teresi J, et al. (2006). Development, validation, and use of English and Spanish versions of the telemedicine satisfaction and usefulness question-naire. Journal of the American Medical Informatics Association : JAMIA, 13(6), 660–667. https://-doi.org/10.1-197/jamia.M2146
Bali, S. (2018) ‘Barriers to Development of Telemedicine in Developing Coun-tries’, Telehealth [Preprint].
Ceci SJ, Williams WM (2007) Why aren’t more women in science?: Top researchers debate the evidence., Why aren’t more women in science?: Top researchers debate the evidence. Washington, DC, US: American Psyc-hological Association. Available at: https://doi.org/10.1037/11546-000.
Chang H (2015). Evaluation framework for telemedicine using the logical frame-work approach and a fishbone diagram, Healthcare Informatics Research, 21(4), pp. 230–238. Available at: https://doi.org/10.4258/hir.20-15.21-.4.230.
Chowdhury SR, Sunna TC, Ahmed, S (2021). Telemedicine is an important aspect of healthcare services amid COVID-19 outbreak: Its barriers in Bangladesh and strategies to overcome, The International Journal of Health Planning and Management, 36(1), pp. 4–12. Available at: https://doi.org/https://doi.org/10.1002/hpm.3064.
Christasani PD, Satibi (2016). Kajian Faktor Demografi terhadap Kepu-asan Pasien Jaminan Kesehatan Nasional pada Fasilitas Kesehatan Tingkat Pertama’, Jurnal Farmasi Sains dan Komunitas, 13(1), pp. 28–34. DOI: https://do-i.org/10.24071/-jpsc.00127
Cubanski J (2020). Possibilities and Limits of Telehealth for Older Adults During the COVID-19 Emergency, Kaiser Family Foundation. Available at: https://www.kff.org/corona-vir-us-policywatch/possibilities and-li-mits-of-telehealth-for-older adults-during-the-covid-19-emergency/ (Accessed: 23 July 2020).
Gugus Tugas Percepatan Penanganan COV-ID-19 (2020) Peta Sebaran COVID-19, Gugus Tugas Percepatan Penanganan COVID-19. Available at: https://covid-19.go.id/peta-seba-ran (Accessed: 10 July 2020).
Gusmawan F, Haryadi, Sutrisna E (2019). Pengaruh Kualitas Layanan dan Karak-teristik Sosiodemografi terhadap Minat Kunjungan Ulang yang Dimo-derasi Oleh Kepuasan Pasien pada Pelayanan Rawat Jalan Puskesmas Kedungbanteng Kabupaten Banyumas, Jurnal Ekonomi, Bisnis dan Akuntansi (JEBA), 21(4), pp. 1–15.
Hadiyat YD (2014) Kesenjangan Digital di Indonesia (Studi Kasus di Kabupaten Wakatobi)’, Pekommas, 17(2), pp. 81–90.
Herwando H, Sitompul TH (2021). Evaluasi Manfaat Penerapan Telemedicine di Negara Kepulauan: Syste-matic Literature Review’, Indonesian of Health Information Management Journal (INOHIM), 9(2), pp. 91–101. Available at: https://doi.org/10.4-7007/inohim.v9i2.261.
Hitayani, W. and Oktamianti, P. (2022) ‘Penggunaan Telemedicine pada Pasien Kaki Diabetik di Era Pandemi’, Syntax Literate: Jurnal Ilmiah Indonesia, 7(9), pp. 14626–14638.
Iskandar IW (2017). Pemanfaatan Waktu Luang Pada Buruh Pabrik Di Pt. Yang Ming International Kota Semarang. Universitas Muhammadiyah Sema-rang.
Istifada R, Sukihananto, Laagu MA (2017). Pemanfaatan Teknologi Telehealth pada Perawat di Layanan Homecare’, Nursing Current, 5(1), pp. 51–61. https://doi.org/10.19166/nc.v5i1.1102
Juariyah (2012). Miskomunikasi Antar budaya Mahasiswa Pendatang di Kabupaten Jember’, Jurnal Ilmu Komunikasi, 10(3), pp. 251–261. DOI: https://doi.org/10.31315/jik-.v10i3.45
Le LB, Rahal HK, Viramontes MR, Meneses KG, Dong TS, Saab S (2019). Patient Satisfaction and Healthcare Utilization Using Telemedicine in Liver Transplant Recipients. Digestive diseases and sciences, 64(5), 1150–1157. https://doi.org/-10.1007/s106-20-018-5397-5
Litbangkes Baturaja (no date) ‘Aplikasi Telemedicine Berpotensi Merevolusi Pelayanan Kesehatan di Indonesia’, Balai Penelitian dan Pengembang-an Kesehatan Baturaja.
Litvak M, Miller K, Boyle T, Bedenbaugh R, Smith C, Meguerdichian D, Reis-man D, et al. (2022). Telemedicine Use in Disasters: A Scoping Review. Disaster medicine and public health preparedness, 16(2), 791–800. https://doi.-org/10.1017/dmp.2020.473
Martinez KA, Rood M, Jhangiani N, Kou L, Rose S, Boissy A, Rothberg MB (2018). Patterns of Use and Correlates of Patient Satisfaction with a Large Nationwide Direct to Consumer Telemedicine Service. Journal of General Internal Medicine, 33(10), 1768–1773. https://doi.org/10.1007-/s11606-018-4621-5.
Nihayati and Laksmi (2020). Perilaku pencarian informasi pekerjaan oleh sarjana fresh graduate dengan analisis Model Wilson. Berkala Ilmu Per-pustakaan dan Informasi, 16(1), pp. 55–67.
Ohannessian R, Duong TA, Odone A (2020). Global Telemedicine Implementation and Integration Within Health Systems to Fight the COVID-19 Pandemic: A Call to Action. JMIR public health and surveillance, 6(2), e18810. https://doi.org/10.2196/18-810
Orlando JF, Beard M, Kumar S (2019). A systematic review of patient and caregivers' satisfaction with telehealth videoconferencing as a mode of service delivery in managing patients' health. PloS one, 14(8), e0221848. https://doi.org/10.1371/-journal.pone.0221848.
Pratama V, Bernarto I (2022). The Relationship between Health Service Quality, Servicescape, and Socio-demographic Factors on Outpatient Satisfaction Levels at Clinic X. Budapest International Research and Critics Institute (BIRCI-Jour-nal), 5(1), pp. 3337–3349. DOI: https://doi.org/10.-33258/birci.v5i1.4001
PUSKAKOM UI (2015) FIXED BROADBAND SATISFACTION SURVEY: A Study on Residential and Business Broadband Users in Indonesian Cities. Depok.
Schoenfelder T, Klewer J, Kugler J (2010). Factors associated with patient satisfaction in surgery: the role of patients' perceptions of received care, visit characteristics, and demo-graphic variables. The Journal of surgical research, 164(1), e53–e59. https://doi.org/1-0.1016/j.jss.2010.08.001.
Schroeder C (2019). A pilot study of telemedicine for the initial evaluation of general surgery patients in the clinic and hospitalized settings. Surgery Open Science, 1(2). Available at: https://doi.org/10.1-016/j. sopen.2019.06.005.
Schwamm LH, Chumbler N, Brown E, Fonarow GC, Berube D, Nystrom K, Suter R, et al. (2017). Recommendations for the Implementation of Telehealth in Cardiovascular and Stroke Care: A Policy Statement From the American Heart Association. Circulation, 135(7), e24–e44. https:-//doi.org/10.1161/CIR.0000000000000475.
Scott Kruse C, Karem P, Shifflett K, Vegi L, Rav K, Brooks M (2018). Evaluating barriers to adopting telemedicine worldwide: A systematic review. J Telemed Telecar, 24(1), 4–12. doi.o-rg/10.1177/1357633X16674087
Sumarwan, U. (2002) Perilaku Konsu-men. Penerbit Ghalia Indonesia.
Syarifain A, Rumayar AA, Mandagi CKF (2017). Hubungan Antara Pendidikan Dan Pendapatan Dengan Pemanfaatan Pelayanan Kesehatan Oleh Pasien Bpjs Di Wilayah Kerja Puskesmas Sario Kota Manado. Kesmas: Jurnal Kesehatan Masya-rakat Universitas Sam Ratulangi
Terry, W.S. (2017) Learning and Memory: Basic Principles, Processes, and Procedures. 5th Editio. New York: Routledge. Available at: https://doi.-org/https://doi.org/10.4324/9781315622781.
Utomo IC, Rokhmah S, Widodo DAP (2015). Analisis dan Perbandingan Tingkat Pemahaman Teknologi Info-rmasi pa-da Anak di Desa Tertinggal dengan Perkotaan Sebagai Upaya Peningkatan Pemahaman Teknologi Informasi di Desa Tertinggal’, Jurnal Ekonomi dan Teknik Informatika, 3(5), pp. 48–54.
Wade, C. and Tavris, C. (2007) Psikologi Edisi Kesembilan Jilid 2. Erlangga.
Welch BM, Harvey J, O'Connell NS, McElligott JT (2017). Patient preferences for direct-to-consumer telemedicine services: a nationwide survey. BMC health services research, 17(1), 784. https://doi.org-/10.1186/s12913-017-2744-8.