Differences in Digital Health Use of Rural–Urban Medicare Beneficiaries

Abstract

Digital health inequities appear to exist between rural–urban older adults, a problem exacerbated by the COVID-19 pandemic. This study investigated the differences in digital health use (DHU) between rural–urban Medicare beneficiaries using the 2021 National Health and Aging Trends Study. Led by the Senior Technology Acceptance Model, separate multiple linear regression models examined the relationship between DHU, social determinants, and technology readiness by residence. The results showed that Black urban older adults were more likely to engage in DHU than their White counterparts, and men across both samples were more likely to partake in DHU than women. Tablet access best predicted rural DHU, whereas computer access best predicted urban DHU. Online grocery shopping was the most significant technology experience for rural residents, whereas online banking led for urban residents. Nurses and other health professionals can introduce digital health applications in clinic or at bedside to build older adults’ technology experience. To improve digital health equity, the policies and implementation of digital interventions should consider locality, device ownership, and user interface familiarity of Medicare beneficiaries.