Understanding trust in mandatory telemedicine use during COVID-19: a modified health belief model approach

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not reported in abstract

• Primary Outcome: Trust in telemedicine positively influenced by self-efficacy, service quality, and perceived cost

• Nnt Or Sensitivity: Trust identified as key mediator for continued telemedicine use intention

• Confidence Interval: Not reported

Clinical Application

Findings suggest focusing on user self-efficacy and service quality rather than health risk messaging Limited applicability as Australia's telemedicine adoption was largely voluntary; however, insights on service quality and user confidence remain relevant for Medicare-subsidised telehealth services COVID-19 patients and potentially other patients using telemedicine during mandatory or emergency conditions

Abstract

PURPOSE: This study explores the determinants of trust in telemedicine when its use was mandated during the COVID-19 pandemic in South Korea. It extends the health belief model by incorporating two service related constructs: service quality and perceived cost. DESIGN/METHODOLOGY/APPROACH: An online survey was conducted with 288 individuals who were confirmed COVID-19 patients and required to use telemedicine services during isolation. Partial least squares structural equation modeling was applied to examine the relationships between health beliefs including perceived severity, perceived susceptibility and self-efficacy, service perceptions such as service quality and perceived cost, trust in telemedicine and behavioral intention to use telemedicine services. FINDINGS: The results showed that self-efficacy, service quality and perceived cost positively influenced trust in telemedicine. In contrast, perceived severity and perceived susceptibility did not have a meaningful impact. Trust was found to be a key factor in shaping patients' intention to continue using telemedicine services. Overall, the proposed model was supported, highlighting the importance of confidence and service related perceptions in building trust under mandatory usage conditions. ORIGINALITY/VALUE: This study provides empirical evidence on trust formation under mandatory telemedicine use, a scenario rarely explored in the literature. It demonstrates that trust is primarily driven by users' self-efficacy and service perceptions rather than by health risk perceptions, offering practical guidance for enhancing remote care engagement during policy enforced use conditions.

References

1. 1.Shin, S., & Lee, W. J. (2026). Understanding trust in mandatory telemedicine use during COVID-19: a modified health belief model approach. International Journal of Health Care Quality Assurance. https://doi.org/10.1108/IJHCQA-07-2025-0084