Journal article
Understanding rural‐urban differences in veterans’ internet access, use and patient preferences for telemedicine
The Journal of rural health, Vol.40(3), pp.438-445
Summer 2024
DOI: 10.1111/jrh.12805
PMID: 37935649
Appears in UI Libraries Support Open Access
Abstract
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 To examine veteran‐reported broadband access, internet use, familiarity with, and preferences for telemedicine stratified by residential rurality. 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 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 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.
Details
- Title: Subtitle
- Understanding rural‐urban differences in veterans’ internet access, use and patient preferences for telemedicine
- Creators
- Amy M. J. O'Shea - VA Office of Rural Health Veterans Rural Health Resource Center‐Iowa City (VRHRC‐IC), Iowa City Veterans Affairs Health Care System Iowa City Iowa USA, Center for Access and Delivery Research and Evaluation (CADRE), The Iowa City VA Healthcare System Iowa City Iowa USA, Department of Internal Medicine University of Iowa Carver College of Medicine Iowa City Iowa USAMikayla Gibson - Department of Human Physiology University of Iowa College of Liberal Arts and Sciences Iowa City Iowa USAJames Merchant - University of Iowa, BiostatisticsKelby Rewerts - Iowa City VA Health Care SystemKelly Miell - Iowa City VA Health Care SystemPeter J. Kaboli - Iowa City VA Health Care SystemStephanie L. Shimada - Bedford VA Research Corporation
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.40(3), pp.438-445
- DOI
- 10.1111/jrh.12805
- PMID
- 37935649
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Publisher
- Wiley
- Grant note
- DOI: 10.13039/100006379, name: Office of Research and Development; DOI: 10.13039/100000738, name: U.S. Department of Veterans Affairs
- Language
- English
- Electronic publication date
- 11/07/2023
- Date published season
- Summer 2024
- Date published
- 2024
- Academic Unit
- Occupational and Environmental Health; Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984507159802771
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