TY - JOUR AU - Dang, Stuti AU - Muralidhar, Kiranmayee AU - Li, Shirley AU - Tang, Fei AU - Mintzer, Michael AU - Ruiz, Jorge AU - Valencia, Willy Marcos PY - 2022 DA - 2022/4/8 TI -老年高危退伍军人视频访问意愿和可及性的差距:横断面研究JO - J Med Internet Res SP - e32570 VL - 24 IS - 4 KW -高风险退伍军人KW -老年人KW -远程医疗KW -视频访问KW -健康差距KW -区域剥夺指数KW -移动电话AB -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。在使用国家退伍军人事务数据的预测模型确定的HNHR退伍军人中，我们评估了使用视频就诊进行医疗保健的意愿、获得必要设备的机会以及使用技术的舒适度。我们评估了身体健康，包括虚弱、身体功能、日常生活活动表现(ADL)和工具性ADL (IADL);心理健康;社会需求，包括地区剥夺指数、交通、社会支持和社会隔离。结果:602名高人力资源退伍军人的平均年龄为70.6岁(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. SN - 1438-8871 UR - //www.mybigtv.com/2022/4/e32570 UR - https://doi.org/10.2196/32570 UR - http://www.ncbi.nlm.nih.gov/pubmed/35394440 DO - 10.2196/32570 ID - info:doi/10.2196/32570 ER -