Telehealth Use by Residence Type in Older Adults Receiving Long-Term Services and Supports: The US National Core Indicators Survey (2021-2022).

Urbanski DP, Parikh RR, Wolf JM, Langworthy BW, Jutkowitz E, Shippee TP. Telehealth Use by Residence Type in Older Adults Receiving Long-Term Services and Supports: The US National Core Indicators Survey (2021-2022). Journal of The American Medical Directors Association. 2025 Dec 8; 27(2):105996, DOI: 10.1016/j.jamda.2025.105996.

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Abstract:

OBJECTIVES: Telehealth can improve access to geriatric care, especially for vulnerable older adults facing transportation, mobility, and/or health-related barriers to in-person care. However, integrating telehealth into geriatric care requires consideration of the different residence types where older adults use telehealth. This study aimed to examine whether telehealth use among older adults using long-term services and supports (LTSS) differs by residence type, after adjusting for demographic and health-related factors, using data from the National Core Indicators-Aging and Disabilities Adult Consumer Survey. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: We used data from the 2021-2022 National Core Indicators-Aging and Disabilities Adult Consumer Survey for LTSS users aged 65 years without intellectual or developmental disability. METHODS: We compared the proportion of telehealth users across residence types (community-dwelling, residential care, and nursing home), adjusting for sociodemographic and health-related factors, using multivariable logistic regression with state random effects. RESULTS: Of the 6925 respondents in the analytical sample, 4789 (69%) lived in the community, 1381 (20%) lived in residential care, and 755 (11%) were in nursing homes. Telehealth use was reported by 39% of community-dwelling respondents, 34% in residential care, and 20% in nursing homes. The regression model revealed that individuals in residential care and nursing homes had significantly lower adjusted odds of telehealth use than their community-dwelling counterparts [residential care: odds ratio (OR), 0.80; 95% CI, 0.69-0.92; nursing homes: OR, 0.37; 95% CI, 0.29-0.47]. Notably, nursing home residents had lower adjusted odds of telehealth use than those in residential care (OR, 0.46; 95% CI, 0.36-0.60). CONCLUSIONS AND IMPLICATIONS: Older LTSS users in residential care and nursing homes have significantly lower adjusted odds of using telehealth than those living in the community. These findings underscore the importance of considering residential context when evaluating telehealth access and delivery among older adults, particularly those using LTSS.