Internet Use and Satisfaction with Medical Services Among Older Adults in China: Counterfactual Estimation Based on Propensity Score Matching

Abstract

ObjectivesIn the context of China's "Internet Plus Healthcare" reform, this study aims to test whether the use of the Internet has improved older adults’ satisfaction with overall medical services (SMS), and analyze the effectiveness of the reform in the older population. MethodsBased on the cross-sectional data from the China Family Panel Studies in 2020, propensity score matching (PSM) models were employed to examine the relationship between internet use and SMS of Chinese older adults (4661 observations aged 60 and above), and ordinary least square (OLS) regression models were adopted to explore the mediating role of self-rated health (SH) in this relationship. ResultsInternet use was associated with a decline in SMS among older adults in China, with Internet users’ SMS being about 18% lower than non-users. However, we found no evidence for SH mediating the relationship between internet use and SMS, which is contrary to our expectation. ConclusionsInternet use has led to lower levels of SMS among Chinese older adults. In the future, the government needs to further promote the achievements of the “Internet Plus Healthcare” reform to benefit senior citizens more equitably and ultimately improve their SMS. Public Interest SummaryThis research showed that internet use has led to a decrease in satisfaction with overall medical services (SMS) among older adults in China. This result could assist decision-makers in better understanding the healthcare reform achievement and how to further expand the effectiveness of health governance.