Understanding rural-urban differences in veterans' internet access, use and patient preferences for telemedicine.
internet access
primary data
survey
telemedicine
veterans
Journal
The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
ISSN: 1748-0361
Titre abrégé: J Rural Health
Pays: England
ID NLM: 8508122
Informations de publication
Date de publication:
07 Nov 2023
07 Nov 2023
Historique:
revised:
25
09
2023
received:
08
06
2023
accepted:
26
10
2023
medline:
8
11
2023
pubmed:
8
11
2023
entrez:
7
11
2023
Statut:
aheadofprint
Résumé
The expansion of telemedicine (e.g., telephone or video) in the Veterans Health Administration (VA) raises concerns for health care disparities between rural and urban veterans. Factors impeding telemedicine use (e.g., broadband, digital literacy, age) disproportionally affect rural veterans. To examine veteran-reported broadband access, internet use, familiarity with, and preferences for telemedicine stratified by residential rurality. Three hundred fifty veterans with a VA primary care visit in March 2022 completed a 30-min computer-assisted telephone interview. The sampling design stratified veterans by residential rurality (i.e., rural or urban) and how primary care was delivered (i.e., in-person or by video). Counts and weighted percentages are reported. After accounting for survey weights, 96.2% of respondents had in-home internet access and 89.5% reported functional connection speeds. However, rural- compared to urban-residing veterans were less likely to experience a telemedicine visit in the past year (74.1% vs. 85.2%; p = 0.02). When comparing telemedicine to in-person visits, rural versus urban-residing veterans rated them not as good (45.3% vs. 36.8%), just as good (51.1% vs. 53.1%), or better (3.5% vs. 10.0%) (p = 0.05). To make telemedicine visits easier, veterans, regardless of where they lived, recommended technology training (46.4%), help accessing the internet (26.1%), or provision of an internet-enabled device (25.9%). Though rural-residing veterans were less likely to experience a telemedicine visit, the same actionable facilitators to improve telemedicine access were reported regardless of residential rurality. Importantly, technology training was most often recommended. Policy makers, patient advocates, and other stakeholders should consider novel initiatives to provide training resources.
Sections du résumé
BACKGROUND
BACKGROUND
The expansion of telemedicine (e.g., telephone or video) in the Veterans Health Administration (VA) raises concerns for health care disparities between rural and urban veterans. Factors impeding telemedicine use (e.g., broadband, digital literacy, age) disproportionally affect rural veterans.
PURPOSE
OBJECTIVE
To examine veteran-reported broadband access, internet use, familiarity with, and preferences for telemedicine stratified by residential rurality.
METHODS
METHODS
Three hundred fifty veterans with a VA primary care visit in March 2022 completed a 30-min computer-assisted telephone interview. The sampling design stratified veterans by residential rurality (i.e., rural or urban) and how primary care was delivered (i.e., in-person or by video). Counts and weighted percentages are reported.
FINDINGS
RESULTS
After accounting for survey weights, 96.2% of respondents had in-home internet access and 89.5% reported functional connection speeds. However, rural- compared to urban-residing veterans were less likely to experience a telemedicine visit in the past year (74.1% vs. 85.2%; p = 0.02). When comparing telemedicine to in-person visits, rural versus urban-residing veterans rated them not as good (45.3% vs. 36.8%), just as good (51.1% vs. 53.1%), or better (3.5% vs. 10.0%) (p = 0.05). To make telemedicine visits easier, veterans, regardless of where they lived, recommended technology training (46.4%), help accessing the internet (26.1%), or provision of an internet-enabled device (25.9%).
CONCLUSIONS
CONCLUSIONS
Though rural-residing veterans were less likely to experience a telemedicine visit, the same actionable facilitators to improve telemedicine access were reported regardless of residential rurality. Importantly, technology training was most often recommended. Policy makers, patient advocates, and other stakeholders should consider novel initiatives to provide training resources.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Veterans Health Administration
Organisme : VA Office of Rural Health
Organisme : Veterans Rural Health Resource Center-Iowa City
ID : 03806
Organisme : Office of Research and Development
Organisme : Health Services Research and Development (HSR&D) Service through the Comprehensive Access and Delivery Research and Evaluation (CADRE) Center
ID : CIN 13-412
Organisme : U.S. Department of Veterans Affairs
Informations de copyright
Published 2023. This article is a U.S. Government work and is in the public domain in the USA. The Journal of Rural Health published by Wiley Periodicals LLC on behalf of National Rural Health Association.
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