数字鸿沟视角下老年人就医障碍研究

Research on the Barriers of Elderly People Seeking Medical Treatment from the Perspective of Digital Divide

摘要: 在人口老龄化与医疗数字化转型的双重背景下，老年人群体面临的“就医数字鸿沟”问题日益凸显。本研究基于数字鸿沟理论，采用文献分析与理论推演相结合的方法，系统探讨老年人在利用数字化医疗服务过程中遭遇的多重障碍及其形成机制。研究发现，老年人就医数字鸿沟呈现“三道沟”的层级特征：第一道“接入沟”体现为智能设备可及性与网络基础设施的区域差异；第二道“使用沟”表现为数字技能欠缺、操作困难以及适老化设计不足；第三道“知识沟”则反映在健康信息辨识能力有限、虚假信息甄别困难等方面。进一步分析表明，个体因素(生理机能衰退、认知能力下降、心理焦虑)、技术因素(界面复杂、交互不畅、安全隐忧)、社会因素(家庭支持不足、社区培训缺失、医疗系统适配滞后)共同构成了老年人就医障碍的复杂成因网络。在此基础上，本文从适老化技术设计、社会支持体系建设、医疗服务模式创新三个维度提出弥合数字鸿沟的对策建议，以期为推进老年友好型数字医疗建设提供理论参考与实践启示。

Abstract: Against the backdrop of population aging and the digital transformation of healthcare, the “digital divide in healthcare access” faced by older adults has become increasingly prominent. Based on digital divide theory and employing a combination of literature analysis and theoretical deduction, this study systematically examines the multiple barriers encountered by older adults in utilizing digital healthcare services and their formation mechanisms. The research reveals that the healthcare digital divide among older adults exhibits a “three-level chasm” characteristic: the first level “access divide” manifests as regional disparities in smart device availability and network infrastructure; the second level “usage divide” appears as lack of digital skills, operational difficulties, and insufficient age-friendly design; the third level “knowledge divide” reflects limited health information literacy and difficulties in identifying false information. Further analysis indicates that individual factors (physical decline, cognitive impairment, psychological anxiety), technical factors (complex interfaces, poor interaction, security concerns), and social factors (insufficient family support, lack of community training, inadequate healthcare system adaptation) collectively constitute a complex network of causes underlying older adults’ healthcare access barriers. Based on these findings, this paper proposes countermeasures from three dimensions—age-friendly technology design, social support system construction, and healthcare service model innovation—to bridge the digital divide, aiming to provide theoretical references and practical insights for promoting age-friendly digital healthcare construction.