Use of information communication technologies by older people and telemedicine adoption during COVID-19: a longitudinal study.

OBJECTIVES: To investigate how information communication technology (ICT) factors relate to the use of telemedicine by older people in Ireland during the pandemic in 2020. Furthermore, the paper tested whether the supply of primary care, measured by General Practitioner's (GP) accessibility, influenced people's telemedicine options. METHOD: Based on 2 waves from The Irish Longitudinal Study on Ageing, a nationally representative sample, multivariate logistic models were applied to examine the association between pre-pandemic use of ICTs and telemedicine usage (GP, pharmacist, hospital doctor), controlling for a series of demographic, health, and socioeconomic characteristics. RESULTS: Previously reported having Internet access was a statistically positive predictor for telemedicine usage. The availability of high-speed broadband Internet did not exhibit a statistical association. The association was more prominent among those under 70 years old and non-Dublin urban areas. People with more chronic conditions, poorer mental health, and private health insurance had higher odds of using telemedicine during the period of study. No clear pattern between telemedicine use and differential geographic access to GP was found. DISCUSSION: The important role of ICT access and frequent engagement with the Internet in encouraging telemedicine usage among older adults was evidenced. CONCLUSION: Internet access was a strong predictor for telemedicine usage. We found no evidence of a substitution or complementary relationship between telemedicine and in-person primary care access.

The effect of "smoky" coal bans on chronic lung disease among older people in Ireland.

Globally, coal is still widely used for heating. However, there are concerns about its effect on ambient air quality and health. We estimated the effect of bans prohibiting the sale and use of so-called "smoky coal" on the prevalence of chronic lung disease in older people. Our identification strategy relied on the phased extension of smoky coal bans to Irish towns after 2010. We examined five waves of The Irish Longitudinal Study on Ageing (TILDA), a large nationally representative survey containing detailed information on health, housing, and socio-economic status. Controlling for relevant factors, smoky coal bans reduced the probability that an older person reports being diagnosed with chronic lung disease by between three and five percentage points. In models where we estimated the effect of the ban on the incidence of new cases of chronic lung disease, rather than existing cases, we found the effect was between -0.96 and -2.5 percentage points. Our findings were robust to estimating the model using different sub-samples and control variables. Furthermore, to address potential endogeneity of the ban, we examined subsamples defined by whether participants lived in towns within a range of the population threshold at which the ban was imposed. Estimating our model using these subsamples showed a consistently negative effect of the ban. We also showed parallel trends in health outcomes before the treatment, and that the treatment did not affect attrition from the sample.