Enhancing Healthcare Access Through Telehealth: Patient-Centered Insights from Pakistan’s Primary Care Sector

Background: Pakistan’s healthcare system faces critical challenges, including limited infrastructure and disparities in access between urban and rural regions. Telehealth has emerged as a promising solution to improve accessibility, but patient-centered evidence on its effectiveness and cost-efficiency remains limited. Methods: A cross-sectional quantitative study was conducted from May to December 2023 using a validated, modified patient satisfaction tool. Data were collected from 532 patients via EZShifa’s telehealth platform across Pakistan. Key indicators included satisfaction, trust, comfort, accessibility, and cost. Statistical analyses included chi-square tests, ordinal regression, and independent samples t-tests. Results: High satisfaction was reported with internet connectivity (94.9%), provider behavior (96.6%), consultation fees (93.9%), and diagnostic trust (80.8%). While 67.7% were satisfied with prescribed medications, 30.7% expressed dissatisfaction. Comfort was highest for follow-ups and lab reviews but lower for initial visits with new providers and sensitive discussions. Regression analysis identified comfort score (OR: 20.27, p  < 0.0001) and perceived quality of care (OR: 2.585, p  = 0.004) as significant predictors of telehealth acceptance. The average cost of a teleconsultation was PKR 2,000, compared to PKR 4,800 for in-person care. The incremental cost-effectiveness ratio (ICER) was PKR − 3,111.11, indicating telehealth was both more effective and less costly. Conclusions: Telehealth offers a cost-effective, accessible, and patient-satisfactory alternative to traditional care in Pakistan’s primary healthcare system. These findings support broader telehealth adoption and the development of patient-centered digital health policies.