Telehealth Use and Satisfaction in Primary and Mental Health Care Across Nine High-Income Countries

Objective To examine primary care (PC) and mental health (MH) telehealth utilization and satisfaction across nine high-income countries and identify associated demographic and clinical factors. Patients and Methods We conducted a cross-sectional analysis of the Commonwealth Fund International Health Policy Survey, which was fielded from March through August 2023 and surveyed nationally representative samples of adults aged 18 years or older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Sweden, Switzerland, the United Kingdom, and the United States. Analysis from December 2024 to November 2025 included 17,160 of 21,341 respondents after exclusions. Survey-weighted multivariable logistic regression assessed PC and MH telehealth use and satisfaction. Results Overall, an estimated 25.6% used PC telehealth and 9.0% used MH telehealth (weighted estimates). PC telehealth use ranged from 6.6% (Germany) to 39.7% (Australia) and was associated with female gender (adjusted odds ratio [aOR], 1.47; 95% CI, 1.34-1.63), higher education (aOR, 1.56; 95% CI, 1.40-1.74), above-average income (aOR, 1.28; 95% CI, 1.15-1.43), and chronic conditions (aOR, 1.75; 95% CI, 1.55-1.97). MH telehealth use decreased with age (aOR for ≥65 vs 18-24 years, 0.23; 95% CI, 0.16-0.33) but was not associated with income. Among users, 80.4% were satisfied with PC and 77.6% with MH telehealth. Older adults (≥65 years) using MH telehealth reported higher satisfaction (aOR, 2.79; 95% CI, 1.20-6.47). Conclusion Telehealth adoption varied substantially by country and service type. Income disparities in PC telehealth and low adoption but high satisfaction among older MH telehealth users suggest that equity-focused and age-friendly implementation strategies are needed.