Determinants of and Willingness to Use and Pay for Digital Health Technologies Among the Urban Elderly in Hangzhou, China

Figures & data

Table 1 The Descriptive Statistics for WTU of the Elderly

		Very Willing	Partly Willing	Neutral	Less Unwilling	Not Willing	χ^2	P-value
	Total (n=639)	23 (3.6%)	64(10.0%)	210(32.9%)	169(26.4%)	173(27.1%)
Age(years)
50~59	125(19.6%)	8(34.8%)	23(35.9%)	44(21.0%)	20(11.8%)	30(17.3%)	29.245	0.004
60~69	169(26.4%)	7(30.4%)	14 (21.9%)	54(25.7%)	42(24.9%)	52(30.1%)
70~79	162(25.4%)	5(21.7%)	17(26.6%)	47(22.4%)	48(28.4%)	45(26.0%)
80UP	183(28.6%)	3(13.0%)	10(15.6%)	65(31.0%)	59(34.9%)	46(26.6%)
Gender
Female	367(57.4%)	16(69.6%)	31(48.4%)	116(55.2%)	106(62.7%)	98(56.6%)	5.894	0.207
Male	272(42.6%)	7(30.4%)	33(51.6%)	94(44.8%)	63(37.3%)	75(43.4%)
Education
Other	32(5.0%)	0(0.0%)	4(6.3%)	17(8.1%)	8(4.7%)	3(1.7%)	34.844	0.004
Elementary and Junior High School	447(70.0%)	17(73.9%)	39(60.9%)	125(59.5%)	121(71.6%)	145(83.8%)
Technical secondary and school and high school	113(17.7%)	5(21.7%)	15(23.4%)	45(21.4%)	30(17.8%)	18(10.4%)
Junior college and undergraduate	46(7.2%)	1(4.3%)	6(9.4%)	22(10.5%)	10(5.9%)	7(4.0%)
Master and Doctor	1(0.2%)	0(0.0%)	0(0.0%)	1(0.5%)	0(0.0%)	0(0.0%)
Marriage
Married	477(74.6%)	18(78.3%)	45(70.3%)	164(78.1%)	116(68.6%)	134(77.5%)	6.058	0.195
Unmarried	162(25.4%)	5(21.7%)	19(29.7%)	46(21.9%)	53(31.4%)	39(22.5%)
Children
0	12(1.9%)	0(0.0%)	3(4.7%)	4(1.9%)	4(2.4%)	1(0.6%)	1.770	0.778
1	278(43.5%)	11(47.8%)	32(50.0%)	89(42.4%)	60(35.5%)	86(49.7%)
2~3	318(49.8%)	11(47.8%)	26(40.6%)	109(51.9%)	97(57.4%)	75(43.4%)
≥4	31(4.9%)	1(4.3%)	3(4.7%)	8(3.8%)	8(4.7%)	11(6.4%)
Working status
No	543(85.0%)	18(78.3%)	43(67.2%)	175(83.3%)	155(91.7%)	152(87.9%)	24.261	<0.001
Yes	96(15.0%)	5(21.7%)	21(32.8%)	35(16.7%)	14(8.3%)	21(12.1%)
Exercise
≦1h	464(72.6%)	16(69.6%)	43(67.2%)	131(62.4%)	129(76.3%)	145(83.8%)	24.202	<0.001
2~3h	175(27.4%)	7(30.4%)	21(32.8%)	79(37.6%)	40(23.7%)	28(16.2%)
Medical insurance
Non	7(1.1%)	2(8.7%)	2(3.1%)	1(0.5%)	0(0.0%)	2(1.2%)	26.927	0.008
Rural residents	44(6.9%)	3(13.0%)	4(6.3%)	20(9.5%)	10(5.9%)	7(4.0%)
Urban employed	436(68.2%)	13(56.5%)	45(70.3%)	134(63.8%)	125(74.0%)	119(68.8%)
Urban residents	152(23.8%)	5(21.7%)	13(20.3%)	55(26.2%)	34(20.1%)	45(26.0%)
Income
≦2000	50(7.8%)	3(13.0%)	4(6.3%)	14(6.7%)	18(10.7%)	11(6.4%)	35.041	0.020
2001~4000	342(53.5%)	9(39.1%)	31(48.4%)	108(51.4%)	87(51.5%)	107(61.8%)
4001~6000	188(29.4%)	7(30.4%)	23(35.9%)	59(28.1%)	53(31.4%)	46(26.6%)
6001~8000	46(7.2%)	3(13.0%)	6(9.4%)	21(10.0%)	9(5.3%)	7(4.0%)
8001~10,000	10(1.6%)	0(0.0%)	0(0.0%)	8(3.8%)	1(0.6%)	1(0.6%)
>10,000	3(0.5%)	1(4.3%)	0(0.0%)	0(0.0%)	1(0.6%)	1(0.6%)
Life Satisfaction
1	170(26.6%)	9(39.1%)	20(31.3%)	37(17.6%)	25(14.8%)	79(45.7%)	79.695	<0.001
2	348(54.5%)	9(39.1%)	26(40.6%)	132(62.9%)	102(60.4%)	79(45.7%)
3	111(17.4%)	5(21.7%)	14(21.9%)	37(17.6%)	40(23.7%)	15(8.7%)
4	9(1.4%)	0(0.0%)	3(4.7%)	4(1.9%)	2(1.2%)	0(0.0%)
5	1(0.2%)	0(0.0%)	1(1.6%)	0(0.0%)	0(0.0%)	0(0.0%)
Hospitalization
No	476(74.50%)	14(60.90%)	46(71.90%)	147(70.00%)	123(72.80%)	146(84.40%)	13.892	0.008
Yes	163(25.50%)	9(39.10%)	18(28.10%)	63(30.00%)	46(27.20%)	27(15.60%)
Disability
No	601(94.1%)	22(95.7%)	61(95.3%)	197(93.8%)	156(92.3%)	165(95.4%)	1.770	0.778
Yes	38(5.9%)	1(4.3%)	3(4.7%)	13(6.2%)	13(7.7%)	8(4.6%)
ADL
Fully self-care	592(92.6%)	23(100.0%)	59(92.2%)	190(90.5%)	156(92.3%)	164(94.8%)	13.739	0.089
Partially self-care	43(6.7%)	0(0.0%)	3(4.7%)	20(9.5%)	12(7.1%)	8(4.6%)
Unable to care for themselves	4(0.6%)	0(0.0%)	2(3.1%)	0(0.0%)	1(0.6%)	1(0.6%)

Table 2 WTP of the Elderly for Digital Health Technologies and Differences in Their Characteristics

		Very Willing	Partly Willing	Neutral	Less Unwilling	Not Willing	χ^2	P-value
	Total (n=639)	7(1.1%)	42(6.6%)	141(22.1%)	195(30.5%)	254(39.7%)
Age(years)
50~59	125(19.6%)	1(14.3%)	12(28.6%)	41(29.1%)	31(15.9%)	40(15.7%)	27.936	0.006
60~69	169(26.4%)	2(28.6%)	8(19.0%)	33(23.4%)	50(25.6%)	76(29.9%)
70~79	162(25.4%)	2(28.6%)	7(16.7%)	23(16.3%)	51(26.2%)	79(31.1%)
80UP	183(28.6%)	2(28.6%)	15(35.7%)	44(31.2%)	63(32.3%)	59(23.2%)
Gender
Female	367(57.4%)	5(71.4%)	18(42.9%)	84(59.6%)	116(59.5%)	144(56.7%)	4.869	0.301
Male	272(42.6%)	2(28.6%)	24(57.1%)	57(40.4%)	79(40.5%)	110(43.3%)
Education
Other	32(5.0%)	2(28.6%)	4(9.5%)	6(4.3%)	11(5.6%)	9(3.5%)	43.078	<0.001
Elementary and Junior High School	447(70.0%)	5(71.4%)	25(59.5%)	91(64.5%)	120(61.5%)	206(81.1%)
Technical secondary and school and high school	113(17.7%)	0(0.0%)	10(23.8%)	31(22.0%)	40(20.5%)	32(12.6%)
Junior college and undergraduate	46(7.2%)	0(0.0%)	3(7.1%)	13(9.2%)	23(11.8%)	7(2.8%)
Master and Doctor	1(0.2%)	0(0.0%)	0(0.0%)	0(0.0%)	1(0.5%)	0(0.0%)
Marriage
Married	477(74.6%)	6(85.7%)	28(66.7%)	110(78.0%)	146(74.9%)	187(73.6%)	2.857	0.582
Unmarried	162(25.4%)	1(14.3%)	14(33.3%)	31(22.0%)	49(25.1%)	67(26.4%)
Children
0	12(1.9%)	0(0.0%)	1(2.4%)	3(2.1%)	3(1.5%)	5(2.0%)	15.041	0.239
1	278(43.5%)	1(14.3%)	20(47.6%)	63(44.7%)	75(38.5%)	119(46.9%)
2~3	318(49.8%)	5(71.4%)	20(47.6%)	69(48.9%)	112(57.4%)	112(44.1%)
≥4	31(4.9%)	1(14.3%)	1(2.4%)	6(4.3%)	5(2.6%)	18(7.1%)
Working status
No	543(85.0%)	6(85.7%)	34(81.0%)	105(74.5%)	171(87.7%)	227(89.4%)	17.699	0.001
Yes	96(15.0%)	1(14.3%)	8(19.0%)	36(25.5%)	24(12.3%)	27(10.6%)
Exercise
≦1h	464(72.6%)	5(71.4%)	27(64.3%)	93(66.0%)	126(64.6%)	213(83.9%)	27.034	<0.001
2~3h	175(27.4%)	2(28.6%)	15(35.7%)	48(34.0%)	69(35.4%)	41(16.1%)
Medical insurance
Non	7(1.1%)	0(0.0%)	1(2.4%)	0(0.0%)	4(2.1%)	2(0.8%)	22.237	0.035
Rural residents	44(6.9%)	2(28.6%)	5(11.9%)	9(6.4%)	9(4.6%)	19(7.5%)
Urban employed	436(68.2%)	1(14.3%)	25(59.5%)	104(73.8%)	140(71.8%)	166(65.4%)
Urban residents	152(23.8%)	4(57.1%)	11(26.2%)	28(19.9%)	42(21.5%)	67(26.4%)
Income
≦2000	50(7.8%)	1(14.3%)	2(4.8%)	9(6.4%)	8(4.1%)	30(11.8%)	59.045	<0.001
2001~4000	342(53.5%)	5(71.4%)	13(31.0%)	64(45.4%)	107(54.9%)	153(60.2%)
4001~6000	188(29.4%)	1(14.3%)	18(42.9%)	54(38.3%)	52(26.7%)	63(24.8%)
6001~8000	46(7.2%)	0(0.0%)	6(14.3%)	12(8.5%)	24(12.3%)	4(1.6%)
8001~10,000	10(1.6%)	0(0.0%)	2(4.8%)	2(1.4%)	4(2.1%)	2(0.8%)
>10,000	3(0.5%)	0(0.0%)	1(2.4%)	0(0.0%)	0(0.0%)	2(0.8%)
Life Satisfaction
1	170(26.6%)	6(85.7%)	13(31.0%)	30(21.3%)	34(17.4%)	87(34.3%)	57.639	<0.001
2	348(54.5%)	1(14.3%)	16(38.1%)	83(58.9%)	124(63.6%)	124(48.8%)
3	111(17.4%)	0(0.0%)	9(21.4%)	26(18.4%)	35(17.9%)	41(16.1%)
4	9(1.4%)	0(0.0%)	4(9.5%)	2(1.4%)	1(0.5%)	2(0.8%)
5	1(0.2%)	0(0.0%)	0(0.0%)	0(0.0%)	1(0.5%)	0(0.0%)
Hospitalization
No	476(74.5%)	4(57.1%)	26(61.9%)	103(73.0%)	137(70.3%)	206(81.1%)	12.447	0.014
Yes	163(25.5%)	3(42.9%)	16(38.1%)	38(27.0%)	58(29.7%)	48(18.9%)
Disability
No	601(94.1%)	7(100.0%)	38(90.5%)	132(93.6%)	183(93.8%)	241(94.9%)	1.778	0.776
Yes	38(5.9%)	0(0.0%)	4(9.5%)	9(6.4%)	12(6.2%)	13(5.1%)
ADL
Fully self-care	592(92.6%)	7(100.0%)	36(85.7%)	129(91.5%)	182(93.3%)	238(93.7%)	6.921	0.545
Partially self-care	43(6.7%)	0(0.0%)	5(11.9%)	12(8.5%)	12(6.2%)	14(5.5%)
Unable to care for themselves	4(0.6%)	0(0.0%)	1(2.4%)	0(0.0%)	1(0.5%)	2(0.8%)

Table 3 The Brant Test for Two Models

		χ^2	Degree of Freedom	P > Chi2
WTU	Brant	20.280	13.000	0.088
WTP	Brant	13.330	13.000	0.422

Table 4 The Result of Ordered Logistic Regression for WTU and WTP

	WTU					WTP
	Coef.	P>z	OR	[95% Conf.	Interval]	Coef.	P>z	OR	[95% Conf.	Interval]
Age (50~59)
60~69	0.472	0.083	1.603	0.940	2.735	0.622	0.037	1.863	1.040	3.337
70~79	0.547	0.075	1.728	0.947	3.154	1.004	0.004	2.729	1.374	5.421
80UP	0.813	0.016	2.254	1.167	4.352	0.351	0.335	1.420	0.696	2.898
Gender (Female)
Male	−0.038	0.826	0.963	0.688	1.348	0.075	0.698	1.078	0.737	1.578
Education (other)
Elementary and Junior High School	0.525	0.155	1.690	0.819	3.488	0.328	0.453	1.389	0.589	3.275
Technical secondary and school and high school	0.034	0.935	1.035	0.456	2.349	0.216	0.656	1.242	0.479	3.218
Junior college, undergraduate and above	−0.184	0.700	0.832	0.326	2.119	0.442	0.426	1.555	0.525	4.612
Marriage (Married)
Unmarried	−0.005	0.979	0.995	0.665	1.488	0.034	0.884	1.034	0.658	1.627
Children (0)
1	1.131	0.061	3.100	0.948	10.139	0.509	0.450	1.664	0.444	6.243
2~3	1.120	0.066	3.065	0.930	10.099	0.504	0.456	1.655	0.440	6.219
≥4	1.064	0.137	2.898	0.714	11.769	0.704	0.376	2.022	0.425	9.605
Working status (Employed)
Unemployed	0.566	0.039	1.762	1.030	3.013	0.448	0.120	1.565	0.889	2.755
Exercise (<=1h)
2~3h	−0.471	0.010	0.625	0.437	0.892	−0.398	0.050	0.672	0.451	1.000
Medical insurance (None)
Rural residents	1.041	0.221	2.833	0.534	15.041	−1.591	0.180	0.204	0.020	2.091
Urban employed	2.189	0.008	8.923	1.776	44.831	−0.615	0.594	0.541	0.056	5.180
Urban residents	1.734	0.036	5.662	1.124	28.521	−0.951	0.412	0.387	0.040	3.754
Income (<=2000)
2001~4000	−0.473	0.166	0.623	0.319	1.217	−0.301	0.450	0.740	0.338	1.618
4001~6000	−0.766	0.038	0.465	0.226	0.958	−1.087	0.010	0.337	0.148	0.767
>6000	−0.950	0.028	0.387	0.166	0.902	−1.119	0.024	0.327	0.124	0.861
Life satisfaction	−0.320	0.008	0.726	0.573	0.921	−0.154	0.258	0.858	0.657	1.119
Hospitalization (No)
Yes	−0.629	0.001	0.533	0.367	0.776	−0.498	0.020	0.608	0.399	0.925
Disability (No)
Yes	0.143	0.681	1.154	0.583	2.284	−0.288	0.446	0.749	0.357	1.574
ADL (unable to care for themselves)
Partially self-care	0.423	0.705	1.527	0.171	13.668	−0.658	0.614	0.518	0.040	6.680
Fully self-care	0.617	0.570	1.853	0.220	15.588	−0.434	0.733	0.648	0.054	7.830
/cut1	1.478		1.478	−1.624	4.580	−3.279		−3.279	−7.126	0.569
/cut2	3.374		3.374	0.259	6.488	−1.539		−1.539	−5.377	2.299

Notes: Coef refers to the regression coefficient; OR refers to odds ratio, the proportional odds ratios for the ordered logit model; CI refers to confidence interval.