Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
Int J Public Health. 2024 Jan 5;68:1606184. doi: 10.3389/ijph.2023.1606184. eCollection 2023.
To examine with a population-based longitudinal survey design whether poor health, longstanding activity limitation, impaired cognitive functioning, mental distress, or loneliness predict poor access to healthcare and whether digital competence mediates these associations. The data were from the longitudinal FinHealth -survey gathered in Finland in 2017 and 2020 including 3,771 respondents (57.1% women). Linear regression analyses were used to examine the associations of factors affecting healthcare utilization with access to care adjusted for age, sex, and education. Counterfactual causal mediation framework was used to examine the mediating role of digital competence in the relationships among these factors and access to healthcare. Factors affecting healthcare utilization were associated with poor access to care and these associations were partly mediated by low digital competence. Low digital competence mediated 12%, 9% and 8%, of the associations of impaired cognitive functioning, longstanding activity limitation, and loneliness with poor access to care, respectively. According to our results, one way to improve the access to healthcare among vulnerable groups could be to improve their digital competence.
采用基于人群的纵向调查设计，考察健康状况不佳、长期活动受限、认知功能障碍、精神困扰或孤独是否预示着获得医疗保健的机会较差，以及数字能力是否在这些关联中起中介作用。数据来自于 2017 年和 2020 年在芬兰进行的纵向 FinHealth 调查，共包括 3771 名受访者（57.1%为女性）。线性回归分析用于检验影响医疗保健利用的因素与年龄、性别和教育调整后的医疗保健获取之间的关联。反事实因果中介框架用于检验这些因素与获得医疗保健之间的关系中数字能力的中介作用。影响医疗保健利用的因素与获得医疗保健的机会较差有关，而这些关联在一定程度上是由数字能力较低造成的。认知功能障碍、长期活动受限和孤独与获得医疗保健机会较差之间的关联分别有 12%、9%和 8%是由数字能力较低造成的。根据我们的研究结果，改善弱势群体获得医疗保健的一种方法可能是提高他们的数字能力。
