Association of Telemedicine With Life Satisfaction and Satisfaction With Care in Rural China

Objectives: The effectiveness of telemedicine in rural areas with low-quality primary care remains unclear. This study examined the relationship of telemedicine adoption with life satisfaction and satisfaction with care in rural China. It also investigated the association of telemedicine with health-seeking behaviour, healthcare utilisation and heterogeneity in the type of telemedicine collaboration and the quality of healthcare workforce.

Methods: Data were retrieved from the China Livelihood Survey, a nationally representative multi-level survey conducted in 2021. Ordinary least-squares regression models were employed to analyse the relationship between telemedicine adoption at the village level and rural households’ life satisfaction and satisfaction with healthcare. Propensity score matching was used to address the potential selection bias.

Results: A total of 4638 households were included in the analysis. The results show that telemedicine adoption in village clinics was associated with higher levels of life satisfaction and satisfaction with healthcare among rural households. This improvement was primarily attributed to an increased likelihood of seeking care at primary care facilities, rather than a reduction in healthcare expenditures. The association was stronger when village clinics collaborated with township health centres in telemedicine initiatives, compared to those partnering with higher-level hospitals. Moreover, the association was more pronounced in villages with lower-quality healthcare workers compared to those with higher-quality staff.

Conclusion: These findings highlight telemedicine as an effective tool for improving rural residents’ satisfaction. Strategies such as promoting strengthened telemedicine collaboration at local levels and targeting telemedicine resources to remote areas with deficient primary care workforces are recommended to optimise telemedicine adoption in primary care in China and other developing countries.