Examining healthcare access with physical vs. telehealth options: Promise and peril for socially vulnerable older adults

Abstract

Introduction

This paper seeks to understand barriers to healthcare access faced by socially vulnerable older adults in Chicago using qualitative analysis. As the U.S. population ages, ease of healthcare access by older adults grows in importance. Yet, current literature lacks an examination of pain points and coping strategies in accessing healthcare, specifically by socially vulnerable older adults. This is especially relevant as virtual telehealth access and transportation options that shape healthcare access evolve rapidly.

Methods

In this work, we conduct three listening sessions with 40 total participants to understand the lived experiences of Black and Latino older adults living in low-income areas of Chicago. Transcript data was analyzed using qualitative concept and emotion coding to identify vulnerabilities that older patients face in accessing care.

Results

This work highlights five key takeaways from the qualitative analysis: 1) technology struggles and prospects in accessing healthcare, 2) social resources for coping give rise to tension between dependence and autonomy, 3) system disconnects (medical-pharmacy-transportation) represent key pain points, 4) different means of accessing healthcare (traditional transportation vs. telehealth) are value and emotion ladened, 5) different means of observing lead to new methodological insights.

Conclusion

Overcoming healthcare access barriers for older adults ultimately requires analysis of specific interfaces between infrastructure, healthcare, and communications systems. Solutions should prioritize the autonomy of older adults by offering physical accessibility and customized technology. The three intervention policies recommended in this paper include: health kiosks implementation, digital access classes, and specialized training for transit drivers and medical staff.