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Telehealth Use Among Older Adults Receiving Home- and Community-Based Services: Cross-Sectional Analysis Using the
Dana P Urbanski1, Romil R Parikh2, Benjamin W Langworthy3
1College of Arts and Sciences, Indiana University Bloomington, 2631 E Discovery Pkwy, Bloomington, IN, 47408, United States, 1 440-523-0350.
JMIR Human Factors
|June 2, 2026
Summary
Telehealth use among vulnerable older adults is linked to internet access and health conditions. Older age, male sex, and Black race were associated with lower telehealth use, highlighting disparities in digital health access.
Area of Science:
- Gerontology
- Health Services Research
- Digital Health Equity
Background:
- Telehealth adoption surged during COVID-19, offering potential for improved healthcare access for older adults.
- Limited data exists on telehealth utilization among socially and financially vulnerable older populations.
- Understanding factors influencing telehealth use is crucial for addressing disparities in this demographic.
Purpose of the Study:
- To examine factors associated with postpandemic telehealth use in home-dwelling older adults receiving publicly funded home- and community-based services (HCBS).
- To identify characteristics linked to telehealth utilization among socially and financially vulnerable older adults.
- To interpret findings using the Systems Engineering Initiative for Patient Safety (SEIPS) 3.0 framework.
Main Methods:
- Cross-sectional study of adults aged 65+ using 2021-2022 National Core Indicators-Aging and Disabilities Adult Consumer Survey data.
- Multivariable logistic regression analyzed telehealth use, adjusting for sociodemographic, health, and service-related factors.
- Pearson chi-square tests assessed bivariate associations between internet access and sociodemographic variables.
Main Results:
- 40% of participants (1467/3680) used telehealth; 60% did not.
- Lower telehealth odds observed in older age groups, males, Black individuals, and nonmetropolitan residents.
- Higher telehealth odds linked to multiple non-Alzheimer's diagnoses and Alzheimer's disease and related dementias (ADRD) diagnosis.
- Internet access strongly predicted telehealth use (OR 2.51); younger, female, and White individuals had greater internet access.
Conclusions:
- Telehealth use disparities among older adults receiving HCBS are influenced by individual, technological, and organizational factors.
- The SEIPS 3.0 framework highlights the complex interplay of healthcare system features affecting telehealth adoption.
- Further research is needed to understand mechanisms driving telehealth use variations and address adoption barriers for vulnerable older adults.
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