ABSTRACT
Objective
To assess digital health literacy among older adults in a subacute inpatient setting and identify factors associated with greater digital health literacy to inform equitable implementation of patient-facing digital health initiatives.
Methods
We conducted a cross-sectional survey at a single metropolitan subacute hospital involving patients 65 years and older admitted to two Geriatric Evaluation and Management wards between September 2023 and January 2024. Participants completed a survey capturing demographics, technology use and preferences, along with the validated 8-item eHealth Literacy Scale (eHEALS), whereby a score < 26 indicated low eHealth literacy. Additional questions assessed general interest in digital health. Mean eHEALS scores were calculated and associations with patient characteristics analysed using t-tests.
Results
Forty-four participants (mean age 80.1 years; 61% female) were enrolled. The mean eHEALS score was 23.6 (SD 9.4). Tertiary education, preference for digital appointment notifications and owning at least one electronic device were associated with greater eHEALS scores (all p < 0.01). Sensory impairment and prior telehealth use were not associated with statistically significant differences in scores. Many participants lacked access to digital devices or support to use them.
Conclusions
Older adults in subacute hospital settings demonstrated low eHealth literacy and limited access to digital technologies. Hospitals should consider the heterogeneity of digital skills and access among older patients when implementing digital health solutions. Tailored support, inclusive design and infrastructure investment are essential to avoid exacerbating digital health inequities in inpatient care.