Enhancing healthcare access through telehealth: patient-centred insights from Pakistan's primary care sector.

backgroundPakistan's healthcare system faces critical challenges, including limited infrastructure and disparities in access between urban and rural regions. Telehealth has emerged as a promising solution to improve accessibility, but patient-centered evidence on its effectiveness and cost-efficiency remains limited.

methodsThis cross-sectional survey included patients (n = 532) who completed telehealth consultations with EZShifa between May and December 2023. A structured questionnaire assessed socio-demographics, comfort, trust, perceived quality of care, and patient-reported costs. Descriptive statistics summarised characteristics. Ordinal regression identified predictors of telehealth acceptance. Patient-reported telehealth and in-person care costs were compared, and incremental cost-effectiveness ratios (ICERs) were estimated using acceptance and comfort scores as effectiveness measures.

resultsMost participants were aged 26-50 and from Punjab or Sindh. High satisfaction was reported for provider professionalism and consultation quality, though some concerns about connectivity and privacy remained. Ordinal regression showed that higher comfort (OR 4.15-20.3, p = 0.008) and perceived quality of care (OR 2.59, p = 0.004) significantly predicted acceptance, while sociodemographic factors were non-significant. The mean reported telehealth cost (PKR 2,000) was substantially lower than in-person visits (PKR 4,800). ICER analysis indicated telehealth was dominant, offering cost savings and greater patient-reported effectiveness.

conclusionsTelehealth demonstrates strong acceptance, satisfaction, and economic benefits in Pakistan's primary healthcare system. Despite self-reported costs and cross-sectional design limitations, findings highlight telehealth's potential for scaling chronic disease management and reducing healthcare disparities.