School of Business, Faculty of Business, Education, Law & Arts, University of Southern Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Toowoomba, Australia; Department of Economics, Jagannath University, Dhaka, Bangladesh.
School of Business, Faculty of Business, Education, Law & Arts, University of Southern Queensland, Toowoomba, Australia; Centre for Health Research, University of Southern Queensland, Toowoomba, Australia.
Int J Med Inform. 2021 May;149:104411. doi: 10.1016/j.ijmedinf.2021.104411. Epub 2021 Feb 6.
Existing studies have demonstrated that behavioural barriers impede eHealth usage among senior citizens. However, thus far, no analysis of how such barriers affect elderly people with disabilities (PwD) has been conducted. Thus, the study investigates the predictors of eHealth usage among elderly PwD.
Using data from a 2018 nationwide disability survey comprising 14,798 respondents in Australia, multivariate logistic regression models are used to predict the relationship between eHealth usage and the various characteristics of respondents, including access to information and communication technologies (ICTs), socioeconomic status, and level of education.
Although most participants (approximately 88%) have access to ICTs, few (only around 9%) have used eHealth services. The results show a number of factors are associated with an increased likelihood of using eHealth services, including higher educational attainment (odds ratio [OR] = 3.12, 95% confidence interval [CI]: 2.38, 4.24), employment (OR = 1.43, 95% CI: 1.06, 1.94), higher household income (OR = 1.39, 95% CI: 1.00, 1.96), and ICT access (OR = 15.92, 95% CI: 10.51, 27.01). The probability of eHealth use is lower for the oldest-old (OR = 0.35, 95% CI: 0.22, 0.45). In addition, the estimates from interaction effects suggest the effect of ICT penetration on use of eHealth falls by a negligible amount because of resistive attitudinal barriers (OR = 0.01, 95% CI: 0.01, 0.06).
Given the challenges of ageing populations and pandemics, such as COVID-19, eHealth services are a vital part of an effective, inclusive, and robust health care system. This study demonstrates the presence of a significant digital divide among elderly PwD and suggests that public and private efforts should be made to increase the availability of ICT infrastructure. Training could also increase inclusion in this regard.
现有研究表明，行为障碍阻碍了老年人使用电子健康技术。然而，迄今为止，尚未对这些障碍如何影响残疾老年人进行分析。因此，本研究调查了影响残疾老年人使用电子健康技术的预测因素。
本研究使用了 2018 年澳大利亚全国残疾调查的数据，该调查涵盖了 14798 名受访者。采用多元逻辑回归模型预测受访者的电子健康技术使用情况与受访者的各种特征（包括获取信息和通信技术的情况、社会经济地位和教育水平）之间的关系。
尽管大多数参与者（约 88%）可以使用信息和通信技术，但很少有人（仅约 9%）使用电子健康服务。结果显示，有几个因素与使用电子健康服务的可能性增加有关，包括较高的教育程度（比值比 [OR] = 3.12，95%置信区间 [CI]：2.38，4.24）、就业（OR = 1.43，95%CI：1.06，1.94）、较高的家庭收入（OR = 1.39，95%CI：1.00，1.96）和获取信息和通信技术（OR = 15.92，95%CI：10.51，27.01）。最年长的老年人使用电子健康服务的可能性较低（OR = 0.35，95%CI：0.22，0.45）。此外，交互效应的估计表明，由于存在抵触态度障碍，信息和通信技术普及率对电子健康技术使用的影响略有下降（OR = 0.01，95%CI：0.01，0.06）。
鉴于人口老龄化和大流行病（如 COVID-19）的挑战，电子健康服务是有效、包容和强大的医疗保健系统的重要组成部分。本研究表明，残疾老年人中存在显著的数字鸿沟，并建议公共和私营部门应努力增加信息和通信技术基础设施的可用性。培训也可以在这方面增加包容性。
