Journal Article

Internet-based healthcare services use patterns and barriers among middle-aged and older adults in China: a cross-sectional study

Ma, Yue, Yu, Pingping, Yue, Zhihao, Chen, Chaoyi, Wang, Ziyu, Yan, Zeyu, Ren, Qiaoqiao, Liu, Chaojie, Hao, Yanhua

2025

Overview

Background The global aging trend has intensified chronic disease burdens, widened healthcare access disparities, and exacerbated unmet care needs. Internet‑based Healthcare Services (IHS) present a promising strategy to address these challenges. This study investigates the prevalence and determinants of IHS use, as well as the primary motivations and barriers to adoption among adults aged 50 years and older in mainland China. Methods An online cross-sectional survey was conducted in March 2021 among adults aged 50 years and older in mainland China. Participants ( N  = 560) were recruited through random sampling on an online platform. Logistic regression models were used to identify predisposing, need, and enabling factors associated with IHS use. Results Only 17.14% of respondents reported using IHS, with online medical consultation being the most common (38.5%). Respondents aged between 50 and 59 years (AOR = 4,975 [95% CI 1.224–19.608]), urban residents (AOR = 6.056 [95% CI 1.689–21.713]), higher income (AOR = 3.862 [95% CI 1.822–8.186]), chronic conditions (AOR = 5.567 [95% CI 2.167–14.301]), delays in seeking healthcare (AOR = 5.323 [95% CI 2.866–9.888]), mobility difficulties (AOR = 9.802 [95% CI 4.005–23.993]), positive attitude (AOR = 3.038 [95% CI 1.039–8.884]) were more likely to use IHS, after adjusting for other variables. The main barriers to IHS use included distrust and uncertainty about describing symptoms online. Conclusion Low levels of IHS use were observed among middle-aged and elderly populations in mainland China. Although IHS can benefit individuals with high healthcare needs or mobility limitations, income-related and urban–rural inequalities in IHS use persist. Addressing trust issues and enhancing digital literacy among the elderly are essential for the widespread and effective development of IHS.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adults / Aged / Aging / Biostatistics / Care and treatment / China / Chronic conditions / Chronic diseases / Chronic illnesses / Cross-Sectional Studies / Data collection / Demographic aspects / Diagnosis / Digital health / Digital Health Adoption / Digital Health Equity / Disease management / Economic aspects / Environmental Health / Epidemiology / Female / Geriatrics / Health aspects / Health care / Health care disparities / Health literacy / Health services / Health Services Accessibility / Healthcare Utilization / Humans / Internet / Internet Medical Services / Likert scale / Low income groups / Male / Medical appointments / Medical equipment / Medicine / Medicine & Public Health / Middle age / Middle Aged / Middle-Aged and Older Adults / Older people / Online health care information services / Patient Acceptance of Health Care - statistics & numerical data / Promoting health equity among aging adults / Public Health / Questionnaires / Random sampling / Regression analysis / Regression models / Risk factors / Rural areas / Secondary schools / Sleep / Social aspects / Social support / Statistical sampling / Surveys and Questionnaires / Telemedicine / Telemedicine - statistics & numerical data / Urban areas / Vaccine / Variables