Age, Gender and Education Shape Who Wants More Telemedicine in Primary Care

Telemedicine has moved from pandemic-era stopgap to a permanent fixture of primary care, but a new survey from Austria suggests that patients are far from uniform in how much more of it they want. A cross-sectional study of 1,404 patients treated at 15 primary care units in the Austrian province of Styria, published in BMC Health Services Research, finds that the intention to use telephone and video consultations more often in the future depends strongly on age, and that the two modalities follow strikingly different sociodemographic patterns.

The research team, led by Laura Plotho and Nicole Posch of the Institute of General Practice and Evidence-Based Health Services Research at the Medical University of Graz, surveyed patients during routine care in September 2025 using a self-administered questionnaire. Participants were asked, in binary items, whether they intended to use telephone-based telemedicine more often and whether they intended to use video-based telemedicine more often. The researchers then ran separate binary logistic regression models for each modality, with gender, age, educational attainment and degree of urbanization as predictors.

The headline finding is a steep age gradient. For telephone consultations, compared with patients aged 18 to 29, the odds of intending to use the service more often fell progressively with each older age band. Patients aged 45 to 59 had roughly 40 percent lower odds, with an odds ratio of 0.599 and a 95 percent confidence interval of 0.414 to 0.868. Among those aged 60 to 74 the odds ratio dropped to 0.244, and among patients aged 75 and older it collapsed to 0.101, meaning the oldest group had about one-tenth the odds of the youngest adults. The pattern for video consultations was similar, though somewhat less pronounced in the middle age bands: patients aged 60 to 74 showed an odds ratio of 0.435, and those 75 and older an odds ratio of 0.128, both statistically significant.

Gender mattered for one modality but not the other. Men had lower odds than women of intending to use telephone consultations more often, with an odds ratio of 0.699 and a confidence interval of 0.545 to 0.898. For video consultations, however, no comparable gender difference emerged in the reported results. This asymmetry is one of the study’s most interesting technical observations, because it suggests that the barriers and appeal of the two modalities are not simply two flavors of the same digital phenomenon.

Instead, education and geography split the picture further. Higher educational attainment and residence in densely populated areas were both associated with greater intention to use video consultations, with p-values below .001 and .009 respectively. Neither of these factors showed the same association for telephone consultations in the reported findings. The authors interpret this as evidence that video-based telemedicine carries stronger sociodemographic gradients, potentially because it demands more from patients: a stable internet connection, suitable devices, digital literacy and a private space for a camera-mediated conversation. Telephone consultations, by contrast, rely on infrastructure nearly everyone already possesses.

The statistical architecture of the study is straightforward but well suited to the question. Binary logistic regression estimates the odds of a yes-or-no outcome as a function of predictors, and the odds ratios reported here quantify how much the odds of wanting more telemedicine multiply or shrink as one moves between categories, for instance from the youngest to the oldest age group. Confidence intervals that exclude 1.0 indicate associations unlikely to be due to chance at the conventional threshold. The overall p-values for age, below .001 in both models, signal that the gradient is not a quirk of any single comparison but a consistent trend across the whole age distribution.

What makes these numbers consequential is the population they come from. Primary care is the front door of most health systems, and in Austria, as elsewhere, family practices serve a broad cross-section of society, including many older patients with chronic conditions who are among the most frequent users of medical services. If the patients most likely to need frequent contact with their practice are also the least inclined to shift that contact to the telephone or a video screen, then health systems that push telemedicine as a one-size-fits-all efficiency measure may misread their own demand curves.

The study also fills a genuine evidence gap. The authors note that modality-specific determinants from the patient perspective remain limited, particularly in Austria, where telemedicine regulation and reimbursement have evolved along a distinctive path. By measuring telephone and video uptake intentions separately rather than collapsing them into a single digital-willingness construct, the survey captures a distinction that matters for planning: a practice can reasonably offer phone follow-ups to nearly all patients, but video consultations may concentrate among younger, better-educated urban patients unless additional support is provided.

The practical implication the authors draw is a case for hybrid care models that combine in-person, telephone and video consultations according to patient preferences, digital readiness and clinical context. Such models would treat telemedicine as one channel among several rather than a replacement for the consulting room. For older patients, telephone consultations may serve as a low-threshold entry point into remote care, while video may suit younger patients managing routine issues around work schedules. For rural patients, whose intention to use video was lower than that of their urban counterparts, infrastructure and training may be as decisive as attitude.

The survey was funded by the Styrian Health Fund, which had no role in study design, data collection, analysis or publication, and received ethical approval from the ethics committee of the Medical University of Graz. Data were collected anonymously with informed consent obtained implicitly when patients chose to complete the questionnaire after being informed of the study’s purpose. As the authors themselves frame it, the future of primary care is unlikely to be fully digital or fully face-to-face, but a carefully calibrated mix, one that respects the fact that a 78-year-old and a 25-year-old may want very different things from the same practice, offers the most realistic path to care that is both efficient and equitable.

Subject of Research: Sociodemographic determinants of patient intention to use telephone- and video-based telemedicine in Austrian primary care

Article Title: Determinants of telephone- and video-based telemedicine uptake in primary care: a cross-sectional survey

Article References: Plotho, L., Berger, N., Petschk, K., Radl-Karimi, C., Spary-Kainz, U., Siebenhofer, A., & Posch, N. (2026). Determinants of telephone- and video-based telemedicine uptake in primary care: a cross-sectional survey. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15868-2

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15868-2

Keywords: telemedicine, primary care, telephone consultation, video consultation, digital health, cross-sectional survey, Austria, sociodemographic predictors, health services research, aging population, patient perspective, hybrid care models