Faculty of Global Studies, Justice and Rights, University of Macerata, Macerata, Italy.
Sino-Danish College, University of Chinese Academy of Sciences, Beijing, China.
JMIR Mhealth Uhealth. 2022 Jan 12;10(1):e27272. doi: 10.2196/27272.
In the next 15 to 20 years, the Chinese population will reach a plateau and start to decline. With the changing family structure and rushed urbanization policies, there will be greater demand for high-quality medical resources at urban centers and home-based elderly care driven by telehealth solutions. This paper describes an exploratory study regarding elderly users' preference for telehealth solutions in the next 5 to 10 years in 4 cities, Shenzhen, Hangzhou, Wuhan, and Yichang.
The goal is to analyze why users choose telehealth solutions over traditional health solutions based on a questionnaire study involving 4 age groups (50-60, 61-70, 71-80, and 80+) in 4 cities (Shenzhen, Hangzhou, Wuhan, and Yichang) in the next 10 to 20 years. The legal retirement age for female workers in China is 50 to 55 years and 60 years for male workers. To simulate reality in terms of elderly care in China, the authors use the Chinese definition of elderly for employees, defined as being 50 to 60 years old rather than 65 years, as defined by the World Health Organization.
The questionnaires were collected from Shenzhen, Hangzhou, Wuhan, and Yichang randomly with 390 valid data samples. The questionnaire consists of 31 questions distributed offline on tablet devices by local investigators. Subsequently, Stata 16.0 and SPSS 24.0 were used to analyze the data. O-logit ordered regression and principal component analysis (PCA) were the main theoretical models used. The study is currently in the exploratory stage and therefore does not seek generalization of the results.
Approximately 71.09% (280/390) of the respondents reported having at least 1 type of chronic disease. We started with PCA and categorized all Likert scale variables into 3 factors. The influence of demographic variables on Factors 1, 2, and 3 was verified using analysis of variance (ANOVA) and t tests. The ordered logit regression results suggest that health-related motivations are positively related to the willingness to use telehealth solutions, and trust on data collected from telehealth solutions is negatively correlated with the willingness to use telehealth solutions.
The findings suggest that there is a need to address the gap in community health care and ensure health care continuity between different levels of health care institutions in China by providing telehealth solutions. Meanwhile, telehealth solution providers must focus on improving users' health awareness and lower health risk for chronic diseases by addressing lifestyle changes such as regular exercise and social activity. The interoperability between the electronic health record system and telehealth solutions remains a hurdle for telehealth solutions to add value in health care. The hurdle is that doctors neither adjust health care plans nor diagnose based on data collected by telehealth solutions.
在未来 15 到 20 年内，中国人口将达到峰值并开始下降。随着家庭结构的变化和城市化政策的推进，城市中心对高质量医疗资源的需求将更大，远程医疗解决方案也将推动家庭养老的发展。本文描述了一项关于未来 5 到 10 年内四个城市（深圳、杭州、武汉和宜昌）的老年用户对远程医疗解决方案偏好的探索性研究。
该研究旨在通过问卷调查分析未来 10 到 20 年内四个城市（深圳、杭州、武汉和宜昌）四个年龄组（50-60、61-70、71-80 和 80+）的用户选择远程医疗解决方案而不是传统健康解决方案的原因。中国女性工人的法定退休年龄为 50 至 55 岁，男性为 60 岁。为了模拟中国老年人护理的现实情况，作者使用中国员工对老年人的定义，定义为 50 至 60 岁，而不是世界卫生组织定义的 65 岁。
通过当地调查员在平板电脑上离线分发问卷的方式，从深圳、杭州、武汉和宜昌随机收集了 390 份有效数据样本。问卷由 31 个问题组成。随后，使用 Stata 16.0 和 SPSS 24.0 对数据进行分析。O-logit 有序回归和主成分分析（PCA）是主要的理论模型。该研究目前处于探索阶段，因此不寻求结果的推广。
约 71.09%（280/390）的受访者报告至少有一种慢性病。我们从 PCA 开始，将所有李克特量表变量分为 3 个因素。使用方差分析（ANOVA）和 t 检验验证了人口统计学变量对因素 1、2 和 3 的影响。有序逻辑回归结果表明，健康相关动机与使用远程医疗解决方案的意愿呈正相关，对远程医疗解决方案收集的数据的信任与使用远程医疗解决方案的意愿呈负相关。
研究结果表明，中国需要通过提供远程医疗解决方案来解决社区医疗服务的差距，并确保不同层次的医疗机构之间的医疗服务连续性。同时，远程医疗解决方案提供商必须专注于通过定期运动和社会活动等生活方式的改变来提高用户的健康意识并降低慢性病的健康风险。电子健康记录系统和远程医疗解决方案之间的互操作性仍然是远程医疗解决方案在医疗保健中增值的障碍。障碍在于医生既不根据远程医疗解决方案收集的数据调整医疗保健计划，也不进行诊断。
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