Frequency and Correlates of Online Consultations With Doctors or Therapists in Middle-Aged and Older Adults: Nationally Representative Cross-sectional Study

Abstract

Background A few studies have identified the frequency and correlates of online consultations with doctors or therapists. However, there is a lack of studies using nationally representative data from middle-aged and older adults in Germany. Objective This study aims to determine the frequency and correlates of online consultations with doctors or therapists in Germany. Methods For this study, cross-sectional data were taken from the nationally representative German Ageing Survey (DEAS; n=3067 in the analytical sample; age range 46-98 years). As part of the DEAS, a short survey was conducted between June 8 and July 22, 2020, examining the everyday life and living conditions among these middle-aged and older individuals during the COVID-19 pandemic. The frequency of online consultations with doctors or therapists served as the dependent variable (daily, several times a week, once a week, 1-3 times a month, less often, and never). Multiple logistic regressions were performed. Results In sum, 10.02% (381/3806) of individuals with access to the internet had online consultations with doctors or therapists. Multiple logistic regressions showed that the likelihood of using online consultations with doctors or therapists (compared with those never using such services) was positively associated with higher education (compared with medium education; odds ratio [OR] 1.31, 95% CI 1.01-1.70), living with a partner in the same household (compared with single; OR 1.53, 95% CI 1.05-2.22), poorer self-rated health (OR 1.42, 95% CI 1.16-1.74), increased loneliness (OR 1.45, 95% CI 1.10-1.90), and increased satisfaction with life (OR 1.30, 95% CI 1.03-1.64). Conclusions Study findings suggest that a non-negligible proportion of about 1 out of 10 individuals aged 46 years and over had online consultations with doctors or therapists. However, compared with other countries, this proportion remains small. Knowledge about the correlates of (non)use may assist in identifying corresponding individuals. In times of reshaping the health care system, these efforts in online consultations with doctors or therapists may contribute to addressing patient needs. Moreover, increased use of such services may reduce the risk of getting infected with SARS-CoV-2 by reducing social contact.

Determinants of Telemedicine Service Use Among Middle-Aged and Older Adults in Germany During the COVID-19 Pandemic: Cross-Sectional Survey Study

“…We observed that symptoms of anxiety, depression, or loneliness increased the likelihood of telemedicine use in middle-aged and older adults. Similar to our results, Hajek and König [ 30 ] observed a significant positive association of loneliness and telemedicine use in middle-aged and older adults during the pandemic in Germany. Likewise, Rauschenberg et al [ 33 ] found that psychological distress was associated with the current use of mobile health apps in a representative sample of youth aged 16-25 years from the German general population.…”

“…This clearly highlights the need for further studies on sociodemographic determinants in German samples. Similar to our results, employment status, financial situation, and area lived in were not significantly associated with telemedicine use in other German samples during the pandemic [ 23 30 ]. However, this is in contrast to research from the United States regarding telemedicine use during the pandemic [ 29 47 ].…”

“…Whereas none of the included socioeconomic determinants were associated with telemedicine service use in our sample, some recent studies identified significant relationships. Findings regarding associations of sex and age with telemedicine use were mixed in recent studies conducted during the pandemic in Germany, with some studies observing higher rates of use in male and younger individuals [ 22 23 30-32 undefined undefined ]. When observing age groups in our sample, older age groups (65-74 and ≥75 years) were less likely to use telemedicine.…”

“…This suggests that individuals with severe health limitations preferentially used telemedicine services during the pandemic. Likewise, Hajek and König [ 30 ] found a significant association of poor self-rated health and telemedicine use during the pandemic in Germany. Additionally, a positive association of disease burden and telemedicine use was observed by Harju and Neufeld [ 29 ] in large-scale US samples during the pandemic.…”

“…While some of these studies examined large, nationally representative or quota-based samples [22,23,30], other studies only included convenience or smaller selective samples [31][32][33]. These studies identified potential socioeconomic (male sex, younger age, higher or lower education, living with a partner in the same household, having children younger than 18 years), psychosocial (increased loneliness, increased life satisfaction, severe psychological distress, frequent social isolation, lack of company), healthrelated (poor self-rated health), experience-related (higher electronic literacy, past use of telemedicine) and COVID-19related (higher perceived severity of COVID-19 infection, having had COVID-19 infection, subjective COVID-19related challenges, COVID-19-related cognitive preoccupation, anxiety, and worries) determinants that were positively associated with actual telemedicine use during the pandemic [22,23,[30][31][32][33]. However, more studies including large nationally representative samples from Germany are needed to secure these initial findings.…”