Background

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.

Methods

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.

Results

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).

Conclusion

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.

中文翻译：

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检查残疾人中使用eHealth的决定因素：行为方面的调节作用

背景

现有研究表明，行为障碍阻碍了老年人使用eHealth。但是，到目前为止，尚未对这些障碍如何影响残疾人（PwD）进行分析。因此，本研究调查了老年人PwD中使用eHealth的预测因素。

方法

使用来自2018年全国残疾调查的数据，该调查由澳大利亚的14798名受访者组成，多元logistic回归模型用于预测eHealth的使用与受访者各种特征之间的关系，包括信息和通信技术（ICT）的获取，社会经济地位和水平教育之中。

结果

尽管大多数参与者（约88％）可以使用ICT，但很少（只有约9％）使用过eHealth服务。结果表明，许多因素与使用eHealth服务的可能性增加相关，包括较高的教育程度（赔率[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ICT接入（OR = 15.92，95％CI：10.51，27.01）。对于年龄最大的人，使用eHealth的可能性较低（OR = 0.35，95％CI：0.22，0.45）。此外，交互作用效应的估计表明，ICT渗透对使用eHealth的影响由于电阻性态度障碍而降低了可忽略的程度（OR = 0.01，95％CI：0.01，0.06）。

结论

鉴于人口老龄化和大流行病（例如COVID-19）面临的挑战，电子卫生保健服务是有效，包容和强大的医疗体系的重要组成部分。这项研究表明老年残疾人之间存在着巨大的数字鸿沟，并建议应做出公共和私人努力以增加ICT基础设施的可用性。培训还可以增加这方面的包容性。