Abstract:Background Outpatient services help bridge the care gap between primary and tertiary healthcare. However, little is known about how clinical context affects patient experience in virtual care, particularly since its rise during the COVID-19 pandemic. Objective To examine associations between clinician-patient communication, appointment purpose, clinical discipline, and patient satisfaction with virtual care, including overall rating, willingness to use virtual care again, and perceived helpfulness. Materials and methods This retrospective cross-sectional study analysed data from Virtual Care Surveys conducted in 2020 2022 by the Bureau of Health Information (New South Wales Ministry of Health), which captured patient experiences with phone and video-based care in public hospital outpatient clinics. Outcomes were coded as negative experiences. Analyses applied population weighting, and regression models were adjusted for patient characteristics and survey year to estimate adjusted odds ratios (AORs) and 95% confidence intervals. Results Among 7,513 respondents with complete data reporting virtual care appointments and gender (representing 354,698 patients; mean age 56, 59% female), key predictors of negative virtual care experiences included clinicians not listening carefully [AORs:3.7(2.1,6.7) (poor rating), 2.2(1.3,3.7) (unwillingness), 7.7(3.9,15.2) (unhelpfulness)], and patients lacking trust/confidence in clinicians [AORs: 5.9(3.7,9.7), 1.9(1.1, 3.1), 2.9(1.5,5.5), respectively]. Among the purposes of the appointment, receiving medical diagnosis and advice was related to perceived unhelpfulness [AOR: 1.9 (1.0, 3.5)]. No associations were found for clinical discipline; however, clinicians lacking preparedness increased the odds of experiencing negative outcomes. Positive experiences were more likely to be reported among patients aged 65 and above, females, those from non-English-speaking backgrounds, individuals living in remote areas, and those with more frequent use of virtual care (p < 0.03). Conclusions Virtual care was broadly accepted across outpatient services in New South Wales. However, patient satisfaction was influenced by the quality of communication and clinician preparedness. Targeted training, particularly for diagnostic consultations, may enhance virtual care experiences in Australia and inform best practices globally.
Keywords: Health Systems and Universal Health Coverage (UHC), virtual care, patient experience, outpatient services, clinician-patient communication
