Bridging or widening the gap? The roles of telehealth and health-related social media use in the association between healthcare barriers and perceived quality of care among older adults.

Abstract

With the rapid growth of the aging population, ensuring high perceived quality of care for older adults has become an increasingly critical issue. While telehealth and health-related social media have become important channels for older adults to access health information and services, little is known about their differential associations with perceived quality of care, and how various types of healthcare barriers are linked to their adoption and care outcomes. The aim of this study was to examine the roles of telehealth and health-related social media in the associations between healthcare barriers and perceived quality of care. A secondary analysis was conducted using data from the Health Information National Trends Survey 7 (HINTS 7), focusing on adults aged 60 years and older (N = 1278). Path analysis was employed to examine the relationships between variables. First, offline healthcare barriers (e.g., long wait times) and online information barriers (e.g., difficulty finding or understanding health information) were negatively associated with older adults' perceived quality of care, whereas functional barriers (e.g., hearing, vision, or mobility limitations) and socioeconomic barriers (e.g., transportation difficulties) did not show any significant direct impact. Second, offline healthcare barriers were positively related to telehealth use, which was positively associated with perceived quality of care. Third, offline, functional, and socioeconomic barriers were positively associated with health-related social media use, which in turn was negatively correlated with perceived quality of care. The results of this study clarify how different healthcare barriers relate to older adults' perceived quality of care and show that telehealth can mitigate these barriers, whereas health-related social media is associated with lower perceived quality of care. Health systems should institutionalize age-friendly telehealth, target subsidies and coverage to improve equitable access to older adults. Furthermore, addressing digital exclusion through health literacy programs is needed so that digital health technologies improve, rather than erode, older adults' perceived quality of care.