ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicTelehealth Innovations: Improving Accessibility, Usability and Satisfaction for Older PatientsView all 5 articles
Bridging the Silver–Digital Divide: How Digital Literacy Shapes Diverse Healthcare Utilisation among China's Older Adults—A Cross-Sectional Study in Seven Chinese Cities
Provisionally accepted
- 1School of Philosophy and Sociology, Lanzhou University, Lanzhou, China
- 2School of Public Policy and Administration, Xi'an Jiaotong University, Xi’an, Shaanxi, China
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Background: As of December 2023, China's population aged 60 and above reached 296.97 million, accounting for 21.1% of the total population. The convergence of an aging society and a digital society presents significant challenges for older adults, particularly in terms of digital inclusion and access to healthcare. This study investigates the impact of digital literacy on the consumption of healthcare services among older adults in China and explores the underlying mechanisms involving social support and technology acceptance. Methods:Data from 1107 valid questionnaires from adults aged 60 and above were analyzed. Digital literacy was assessed using a unidimensional 10-item scale developed for this study. Healthcare service consumption was measured using a validated 8-item scale covering two dimensions: therapeutic and preventive services. Data analysis employed OLS regression, mediation, and moderation models.This study adopted a cross-sectional design with two independent waves of surveys (2019 and 2022) to avoid repeated sampling of the same individuals. Results: Digital literacy demonstrated a significant positive effect on the consumption of healthcare services among older adults (p < 0.01), encompassing both therapeutic and preventive services. Age, urban residence, and education level were also significant positive predictors. Both formal and informal social support were identified as significant mediators in this relationship, with informal support exhibiting a stronger mediating effect. Specifically, digital literacy was positively associated with overall healthcare utilisation (β=0.218, 95% CI: 0.182–0.254, p<0.01), therapeutic services (β=0.182, 95% CI: 0.145–0.219, p<0.01), and preventive services (β=0.265, 95% CI: 0.223–0.307, p<0.01). Conclusions: Enhancing digital literacy is a crucial strategy for promoting healthcare service utilization among older adults in an increasingly digitalized society. Policymakers should prioritize improving digital literacy and integrating digital technology into social support systems. fostering technology acceptance can further amplify these positive effects. This study provides empirical evidence for understanding the role of digital literacy in healthcare consumption and offers valuable insights for policy development.Limitations include the small sample size relative to China's total older population (n=1107) and limited geographical coverage (only seven cities), which may restrict the generalisability of findings to remote rural or megacity areas.
Keywords: Digital Literacy, Healthcare consumption, older adults, social support, technology acceptance
Received: 15 Feb 2025; Accepted: 27 Oct 2025.
Copyright: © 2025 ZHANG, Hou and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: CHI ZHANG, zhangchi@lzu.edu.cn
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