Telehealth Use by Residence Type Among Older Adults Receiving Long-Term Services and Supports

TL;DR

Older adults in nursing and residential care use telehealth less than those living in the community, suggesting a need for targeted efforts to improve adoption in these settings.

Contribution

This study identifies disparities in telehealth use by residence type among older adults receiving long-term services and supports.

Findings

Community-dwelling older adults had higher telehealth use (39.2%) compared to those in residential care (33.5%) and nursing facilities (20.3%).

Residents in residential care and nursing facilities had significantly lower adjusted odds of telehealth use compared to community-dwelling individuals.

Nursing facility residents had lower odds of telehealth use than those in residential care.

Abstract

Telehealth can improve access to geriatric care, particularly for vulnerable older adults facing transportation, mobility, and health-related barriers to in-person care. However, integration of telehealth into geriatric care must account for the different residence types where older adults use telehealth. This study examined the association between residence type and telehealth use among older recipients of long-term services and supports (LTSS) using cross-sectional data from the 2021-2022 National Core Indicators-Aging and Disability Adult Consumer Survey. The analytic sample included 6,925 LTSS users aged ≥ 65 years without intellectual or developmental disability: 69.2% lived in the community, 20% in residential care, and 10.9% in nursing facilities. Telehealth use was reported by 39.2% of community-dwelling respondents, 33.5% in residential care, and 20.3% in nursing facilities. Complete-case multivariable logistic regression, adjusting for sociodemographic and health-related factors with state-level random intercepts, revealed that those in residential care and nursing facilities had significantly lower adjusted odds of telehealth use than their community-dwelling counterparts (residential care: OR, 0.80 [95% CI, 0.69-0.92]; nursing facilities: OR, 0.37 [95% CI, 0.29-0.47]), with nursing home residents also having lower adjusted odds than those in residential care (OR, 0.46 [95% CI, 0.36-0.60]). These findings highlight differences in telehealth use among older LTSS users, with those in residential and nursing facilities having lower odds of telehealth use compared to community-dwelling individuals. Targeted efforts to promote telehealth adoption in institutional and congregate care settings may help bridge this gap.