Department of Economics, University of Aberdeen, King's College, Aberdeen AB24 3FX, United Kingdom.
The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Trinity Central, Dublin D02 R590, Republic of Ireland.
J Am Med Inform Assoc. 2023 Nov 17;30(12):2012-2020. doi: 10.1093/jamia/ocad165.
To investigate how information communication technology (ICT) factors relate to the use of telemedicine by older people in Ireland during the pandemic in 2020. Furthermore, the paper tested whether the supply of primary care, measured by General Practitioner's (GP) accessibility, influenced people's telemedicine options.
Based on 2 waves from The Irish Longitudinal Study on Ageing, a nationally representative sample, multivariate logistic models were applied to examine the association between pre-pandemic use of ICTs and telemedicine usage (GP, pharmacist, hospital doctor), controlling for a series of demographic, health, and socioeconomic characteristics.
Previously reported having Internet access was a statistically positive predictor for telemedicine usage. The availability of high-speed broadband Internet did not exhibit a statistical association. The association was more prominent among those under 70 years old and non-Dublin urban areas. People with more chronic conditions, poorer mental health, and private health insurance had higher odds of using telemedicine during the period of study. No clear pattern between telemedicine use and differential geographic access to GP was found.
The important role of ICT access and frequent engagement with the Internet in encouraging telemedicine usage among older adults was evidenced.
Internet access was a strong predictor for telemedicine usage. We found no evidence of a substitution or complementary relationship between telemedicine and in-person primary care access.
调查在 2020 年疫情期间,爱尔兰老年人使用远程医疗的情况与信息通信技术(ICT)因素有何关系。此外,本文还测试了初级保健的供应(以全科医生的可及性衡量)是否会影响人们的远程医疗选择。
基于全国代表性样本爱尔兰老龄化纵向研究的 2 个波次,应用多变量逻辑模型来检验疫情前使用 ICT 与远程医疗使用(全科医生、药剂师、医院医生)之间的关联,同时控制了一系列人口统计学、健康和社会经济特征。
先前报告的互联网接入是远程医疗使用的统计学上的正向预测因素。高速宽带互联网的可用性没有表现出统计学上的关联。这种关联在 70 岁以下和都柏林以外的城市地区更为明显。患有更多慢性病、心理健康状况较差和拥有私人医疗保险的人在研究期间使用远程医疗的可能性更高。在远程医疗使用与 GP 差异化地理可及性之间没有发现明确的模式。
证明了 ICT 接入和频繁上网在鼓励老年人使用远程医疗方面的重要作用。
互联网接入是远程医疗使用的有力预测因素。我们没有发现远程医疗和面对面的初级保健之间存在替代或互补关系的证据。