People with chronic knee pain are willing to pay for telerehabilitation physiotherapy consultations if they offer more communication time, greater pain improvement and less travel and waiting time: a discrete choice experiment.

Abstract

What do people with chronic knee pain value in physiotherapy consultations and how much are they willing to pay for a telerehabilitation consultation as opposed to an in-person consultation? Discrete choice experiment and contingent valuation. A total of 844 Australian adults with a clinical diagnosis of knee osteoarthritis were recruited in April 2021. Participants were presented with a series of hypothetical scenarios and asked to choose between telerehabilitation (videoconferencing) or in-person physiotherapy consultations. Seven attributes (listening and discussion time; choice of physiotherapist; consultation security/privacy; travel time; pain improvement; waiting time; and consultation cost) with varying levels presented in each scenario. A generalised mixed multinomial logit model was used to estimate the strength of preferences across attributes, the implied monetary willingness to pay for telerehabilitation consultations, and the likely uptake of telerehabilitation in the population. Participants were willing to pay AU$38.68 less for a telerehabilitation consultation compared with an in-person consultation. For a plausible set of base case attribute values, 40% of participants chose telerehabilitation. However, preferences for telerehabilitation consults increased when there was less waiting and travel time, more communication time, and when offered at a lower fee. Younger adults, females, those not working, those more confident using videoconferencing technology and those with less knee pain were more likely to prefer telerehabilitation. People with chronic knee pain prefer in-person consultations but there is a demand for telerehabilitation physiotherapy consultations, particularly if offered at a lower fee, if there is a substantial amount of travel and waiting time for an in-person consultation, or if telerehabilitation offers more communication time with the physiotherapist.