JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic has limited the provision of in-person care and accelerated the need for virtual care. Older adults (65+) were one of the highest user groups of in-person health care services prior to the pandemic. Social-distancing guidelines and high rates of mortality from coronavirus infections among older adults made receiving in-person health care services challenging for older adults. The provision of virtual care technologies can help to ensure continuity of care and provide essential health care services during the pandemic to those in high-risk groups at contracting the COVID-19 coronavirus including older adults. It is also essential to understand and address potential socioeconomic, demographic, and health disparities in the demand for use of virtual care technologies among older adults.

Objective:

The objective of this study is to investigate socioeconomic disparities in the demand for and use of virtual visit during the COVID-19 pandemic among older adults in Canada.

Methods:

A cross-sectional web survey was conducted with 12,052 Canadians over the age of 16, selected from Leger’s LEO panel between July 14th to August 6th, 2021. Associations between socioeconomic factors and the demand for and use of virtual visits were tested using the χ2 tests and logistic regression models. Weighting was applied using the 2016 census reference variables to render a representative sample of the Canadian population.

Results:

Approximately 20% (n=2,303) of the survey sample were older adults above the age of 65. The proportion of older adults who expressed demand for telephone visit, video visits, and secure messaging were 69.6%, 49.2%, and 47.2%, respectively. The proportion of older adults in our sample who have used telephone visit in the past 12 months was 47.3%, 9.2%, and 8.4%, respectively. eHealth literacy was positively associated with use of telephone visits (OR 1.03, p=0.01), use of video visits (OR 1.04, p=0.00), and the use of secure messaging (OR 1.03, p=0.00). Income was negatively associated with the use of video visits (OR 0.65, p=0.03). Having no private insurance coverage was negatively associated with use of secure messaging (OR 0.73, p=0.04) but living in a rural community (OR 1.72, p=0.01) and being born outside of Canada (OR 1.50, p=0.03) were positively associated with the use of secure messaging. Education (OR 0.78, p=0.02) and being non-White (OR=0.54, p=0.02) were negatively associated with the use of telephone visits.

Conclusions:

This study found that demand for and use of telephone visit services were more prevalent among older adults during the pandemic. Although demand for secure messaging and video visit is high, usage for these modalities remains low. The results highlight several socioeconomic factors that are associated with demand for virtual visits including language, community size, and health coverage.