Patient acceptance and usability of telemedicine in primary care settings in Saudi Arabia: A cross-sectional study

Abstract

Telemedicine is crucial to primary care, but its success depends on patient perceptions of usefulness, ease, reliability, and satisfaction. Although demographics may influence these views, the actual barriers to digital healthcare might be missed by broad categories. This study evaluated patient ratings across seven telemedicine domains, usefulness, ease of use, interface quality, interaction quality, reliability, satisfaction, and overall acceptance, and examined whether scores differed by age, gender, marital status, education, or employment. This survey of adults at primary care centers in Bisha, Saudi Arabia, ran from June 20, 2026, to July 20, 2026. It included 480 records from 16 PHCCs and comprised 40 demographic variables and 21 items from the Telehealth Usability Questionnaire. Descriptive analyses assessed domain scores via percentile ranks and means/medians. The scores were compared by demographic characteristics using Analysis of Variance (ANOVA) and the Kruskal–Wallis test, with Holm correction for 35 comparisons. Multiple regression evaluated the demographic predictors of acceptance, accounting for heteroskedasticity. All 480 records had complete data for the seven domain-level outcomes. Usefulness had the highest median percentile rank (51.2%), followed by reliability (48.9%) and overall acceptance (48.0%). Ease of use (45.5%) and satisfaction (45.7%) had the lowest. Mean ranks were about 50.1%, as ranks were calculated within each domain. None of the 35 ANOVA comparisons were significant after Holm correction. The largest unadjusted association was between marital status and usefulness, F (2, 477) = 5.53, P = 0.004, η 2 = 0.023; adjusted P = 0.148. Kruskal–Wallis analyses confirmed this. A demographic regression was significant before adjustment, F (13, 466) = 1.92, P = 0.026, but explained only 5.6% of the variance. No individual demographic differences remained significant after adjustment. The findings favor system-wide usability and quality strategies over demographic-specific redesign. Future research should include longitudinal, multicenter studies, clarify questionnaire scoring, and connect patient evaluations with objective outcomes.