JMIR Publications

ABSTRACT

Background:

In an aging and information-based society, older adults have unique perceptions of and demands for digital medical services. The government, healthcare providers, and other sectors of society must comprehend the unique needs of older adults in order to work together to develop a more sensible digital healthcare pattern. This work focused on the adaptation of digitalization for older adults in the process of medical treatment in hospitals.

Objective:

This study aimed to evaluate the behavioral intention and satisfaction of digital medical services among older adults, identify the perceived factors and influence paths related to them.

Methods:

Based on Technology Acceptance Model, perceived risk was incorporated into this study. This study combined qualitative and quantitative analysis. 30 older adults in Hangzhou were invited to participate in the focus group interview, and we transcribed the interviews verbatim and coded them using a grounded-theory approach with open, axial, and selective coding of interview transcripts. We devised our questionnaire and selected four community healthcare centers in Hangzhou by stratified sampling to conduct a face-to-face survey among older adults aged 60 or above who have independent digital medical experience. All the data in the 926 returned questionnaires was valid. The collected data were subjected to descriptive analysis, difference analysis, correlation analysis, mediating effect tests, and a structural equation model.

Results:

The qualitative study condensed the core category of ‘medical service relief and transformation paths for older adults in the context of digital reform’. According to the quantitative analysis, we found the path and degree of influence between the variables. With age, education, residence status, and frequency of medical visits in the last six months as control variables, the pathways of influence in the model held. The mediating effect was also verified: perceived usefulness (a1b1=0.154) and perceived ease of use (a2b2=0.210) mediated between the external variables and behavioral intention, and the external variables would also influence behavioral intention first through perceived ease of use and then through perceived usefulness (a2c1b1=0.107).

Conclusions:

Based on the results of the study and oriented to the needs of older adults, the program aims to assist older adults overcome the dilemma of ‘digital divide’ and improve their willingness and satisfaction with digital medical services. The digital medical products should be modified, strategies should be proposed, and older adults themselves and the community need to put in the effort. Clinical Trial: This study was approved by the Hangzhou Normal University Ethics Committee (REC number 2021-1147).