@Article{info:doi/10.2196/32570，作者=“Dang, Stuti和Muralidhar, Kiranmayee和Li, Shirley和Tang, Fei和Mintzer, Michael和Ruiz, Jorge和Valencia, Willy Marcos”，标题=“老年高危退伍军人视频访问使用意愿和获取的差距:断面研究”，期刊=“J Med Internet Res”，年=“2022”，月=“4”，日=“8”，卷=“24”，数=“4”，页=“e32570”，关键词=“高风险退伍军人;老年人;远程医疗;视频访问;健康差异;区域剥夺指数;背景:最近向视频护理的转变加剧了医疗保健获取的差距，特别是在高需求、高风险(HNHR)的成年人中。制定数据驱动的方法来改善获得医疗服务的机会，需要更深入地了解高人口比率成人对远程医疗和技术获取的态度。目的:本研究旨在了解高退伍军人使用远程医疗的意愿、可及性和能力。方法:我们设计了一份问卷，通过邮件或电话或亲自进行。 Among HNHR veterans who were identified using predictive modeling with national Veterans Affairs data, we assessed willingness to use video visits for health care, access to necessary equipment, and comfort with using technology. We evaluated physical health, including frailty, physical function, performance of activities of daily living (ADL) and instrumental ADL (IADL); mental health; and social needs, including Area Deprivation Index, transportation, social support, and social isolation. Results: The average age of the 602 HNHR veteran respondents was 70.6 (SD 9.2; range 39-100) years; 99.7{\%} (600/602) of the respondents were male, 61{\%} (367/602) were White, 36{\%} (217/602) were African American, 17.3{\%} (104/602) were Hispanic, 31.2{\%} (188/602) held at least an associate degree, and 48.2{\%} (290/602) were confident filling medical forms. Of the 602 respondents, 327 (54.3{\%}) reported willingness for video visits, whereas 275 (45.7{\%}) were unwilling. Willing veterans were younger (P<.001) and more likely to have an associate degree (P=.002), be health literate (P<.001), live in socioeconomically advantaged neighborhoods (P=.048), be independent in IADLs (P=.02), and be in better physical health (P=.04). A higher number of those willing were able to use the internet and email (P<.001). Of the willing veterans, 75.8{\%} (248/327) had a video-capable device. Those with video-capable technology were younger (P=.004), had higher health literacy (P=.01), were less likely to be African American (P=.007), were more independent in ADLs (P=.005) and IADLs (P=.04), and were more adept at using the internet and email than those without the needed technology (P<.001). Age, confidence in filling forms, general health, and internet use were significantly associated with willingness to use video visits. Conclusions: Approximately half of the HNHR respondents were unwilling for video visits and a quarter of those willing lacked requisite technology. The gap between those willing and without requisite technology is greater among older, less health literate, African American veterans; those with worse physical health; and those living in more socioeconomically disadvantaged neighborhoods. Our study highlights that HNHR veterans have complex needs, which risk being exacerbated by the video care shift. Although technology holds vast potential to improve health care access, certain vulnerable populations are less likely to engage, or have access to, technology. Therefore, targeted interventions are needed to address this inequity, especially among HNHR older adults. ", issn="1438-8871", doi="10.2196/32570", url="//www.mybigtv.com/2022/4/e32570", url="https://doi.org/10.2196/32570", url="http://www.ncbi.nlm.nih.gov/pubmed/35394440" }