Jacobs Josephine C, Greene Liberty, SooHoo Sonya, Slightam Cindie, Gujral Kritee, Zulman Donna M
Health Economics Resource Center, VA Palo Alto Health Care System, Menlo Park, CA.
Department of Health Policy, Stanford University School of Medicine, Stanford, CA.
Med Care. 2025 May 1;63(5):374-378. doi: 10.1097/MLR.0000000000002131. Epub 2025 Jan 30.
For nearly a decade, the US Veterans Health Administration (VA) has distributed tablets to Veterans with access barriers who may benefit from video telehealth visits. Older Veterans' lower likelihood of tablet use relative to younger Veterans has prompted interest in factors influencing tablet utilization.
We examined whether social support facilitates video telehealth utilization among older Veterans who received VA tablets.
We performed a cross-sectional analysis of electronic health record-linked survey data. We used multivariable logistic regression to examine the relationship between social support and telehealth use, controlling for predisposing, enabling, and health factors.
Veterans aged ≥65 who received a VA-issued tablet and responded to a national survey (September 2021 to January 2022) (n=859).
The outcome measure was any VA video telehealth use in the 6 months post-tablet receipt. Social support measures included tangible support, living with others, and marital status.
Fewer than two-thirds of respondents (62.4%) had a video visit in the 6 months post-tablet receipt. In all, 32.2% of respondents noted that the absence of family or friends to help with video visits hindered their use of video telehealth. In multivariable analyses, greater tangible social support was associated with 54.1% (95% CI: 10.1%-116.2%) higher odds of having a video visit.
Older adults who receive technological devices to engage in video telehealth benefit from tangible social support from family and friends. Assessing and addressing patients' social and environmental circumstances may help optimize digital divide interventions and ensure that older adults are not excluded from telehealth-related access gains.
近十年来，美国退伍军人健康管理局（VA）一直为那些可能从视频远程医疗就诊中受益但存在获取障碍的退伍军人分发平板电脑。与年轻退伍军人相比，老年退伍军人使用平板电脑的可能性较低，这引发了人们对影响平板电脑使用因素的兴趣。
我们研究了社会支持是否有助于接受VA平板电脑的老年退伍军人使用视频远程医疗。
我们对与电子健康记录相关的调查数据进行了横断面分析。我们使用多变量逻辑回归来研究社会支持与远程医疗使用之间的关系，并控制 predisposing、促成和健康因素。
年龄≥65岁且收到VA发放的平板电脑并回复全国调查（2021年9月至2022年1月）的退伍军人（n = 859）。
结局指标是在收到平板电脑后的6个月内是否使用过任何VA视频远程医疗服务。社会支持指标包括实际支持、与他人同住和婚姻状况。
不到三分之二的受访者（62.4%）在收到平板电脑后的6个月内进行了视频就诊。总体而言，32.2%的受访者指出，没有家人或朋友帮助进行视频就诊阻碍了他们使用视频远程医疗。在多变量分析中，更多的实际社会支持与进行视频就诊的几率高出54.1%（95%CI：10.1%-116.2%）相关。
接受技术设备以参与视频远程医疗的老年人受益于家人和朋友的实际社会支持。评估和解决患者的社会和环境状况可能有助于优化数字鸿沟干预措施，并确保老年人不会被排除在远程医疗相关的获取收益之外。
