Silent Exclusion: An Analysis of the Healthcare Integration Dilemma for the Elderly in Seeking Medical Treatment under Urban Digital Transformation

Yijia Zhang

doi:10.54691/7n73gg10

Authors

Yijia Zhang

DOI:

https://doi.org/10.54691/7n73gg10

Keywords:

Digital divide; Elderly digital disability; Age-friendly design; Digital healthcare.

Abstract

Concurrent urban digital transformation and population aging have exacerbated the technological adaptation challenges and the "silver digital divide" faced by the elderly in healthcare settings. To deeply analyse its manifestations and underlying mechanisms, this study, based on a qualitative investigation in healthcare settings, constructs and validates a three-dimensional analysis framework for this dilemma: "Inability to use" refers to challenges at the operational and comprehension levels; "unwillingness to use" reveals psychological rejection and crisis of trust; and “lack of access” exposes systematic access barriers. The research finds that the root cause of this dilemma lies in the "elderly digital disability”, an intrinsic condition. This decline in ability due to aging is further magnified and solidified by the combined effects of the exclusionary design of external technologies and the inadequate compensatory support from amily and society. To resolve this issue, it is necessary to go beyond superficial technological fixes and establish a multi-stakeholder collaborative governance system where the government provides top-level design and foundational guarantees, the market deepens "genuinely" elderly-friendly adaptations, and society and families strengthen empowering support, to promote society's transition from "digital governance" to "digital good governance.".

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References

[1] Cheung, K., Chau, A., and Woo, J.The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic[J].Archives of Gerontology and Geriatrics, 2023, 115:105225.

[2] Choi,E.Y.,Kim,Y.,and Chipalo, E. Does Perceived Ageism Widen the Digital Divide? And Does It Vary by Gender?[J]. Gerontologist,2020,60(7):1213-1223.

[3] Hunsaker, A., and Hargittai, E.A review of Internet use among older adults[J].New Media&Society, 2018, 20(10): 3937-3954.

[4] Khasawneh,O.Y.Technophobia:Examining its hidden factors and defining it[J].Technology in Society,2018,54:93-100.

[5] Konig, R., Seifert, A., and Doh, M.Internet use among older Europeans: an analysis based on SHARE data[J].Universal Access in the Information Society,2018,17(3):621-633.

[6] Neves, B.B., Waycott, J., and Malta, S.Old and afraid of new communication technologies? Reconceptualising and contesting the"age-based digital divide'[J].Journal of Sociology, 2018, 54(2): 236-248.

[7] Nimrod, G.Not good days for technophobes: older internet users during the COVID-19 pandemic [J]. Educational Gerontology,2021,47(4):160-171.

[8] Ramsetty, A., and Adams, C.Impact of the digital divide in the age of COVID-19[J].Journal of the American Medical Informatics Association,2020,27(7):1147-1148.

[9] van Dijk, J.,and Hacker, K.The digital divide is a complex and dynamic phenomenon[J]. Information Society,2003,19(4):315-326.

[10] Voelter,C.,Thomas,J.P.,and Maetzler,W.Sensory Dysfunction in Old Age[J].Deutsches Arzteblatt International,2021,118(29.30):512.

[11] Wu,Y.,Damnee,S.,and Kerherve, H.Bridging the digital divide in older adults: a study from an initiative to inform older adults about new technologies[J].Clinical Interventions in Ageing, 2015, 10: 193-201.

[12] Yao,Y.,Zhang,H.,and Liu, X.Bridging the digital divide between old and young people in China: challenges and opportunities[J]. Lancet Healthy Longevity,2021,2(3): E125-E126.

[13] Zeng Yongming, Lin Dan. The Road to Bridging: The Impact of Rural Digitalisation on the Digital Divide among Rural Elderly Population [J]. Southern Population, 2025(03): 26-38.

[14] Chen Menggen, Zhou Yuanren. New Advances in Digital Inequality Research [J]. Economic Dynamics, 2022(04): 123-139.

[15] Guo Chen. Hidden Digital Divide Risk for the "Early Old Generation" in Algorithmic Society and the Solution Path [J]. News Enthusiast, 2025(04): 54-56.

[16] Kuang Yalin, Meng Chunyu. Construction of Digital Inclusive Ageing Society from a Global Perspective: Evolutionary Process, Issue Focus and Path Exploration [J]. E-Government, 2025(06): 102-115.

[17] Liu Jianguo, Su Wenjie. The Impact of "Silver Digital Divide" on the Physical and Mental Health of the Elderly — Based on the Data of the Third China Family Panel Survey (CFPS) [J]. Journal of Population Studies, 2022(06): 53-68.

[18] Wang Bin. The Current Situation and Mechanism of Digital Disability among the Elderly in Urban and Rural Areas — Based on the Multi-Dimensional Interpretation Framework of Digital Inequality [J]. Journal of Zhejiang Gongshang University, 2024(05): 156-168.

[19] Wang Xing, Li Qirong, Meng Meng, Yuan Qinjian. Conceptual Construction and Generation Mechanism of Elderly Digital Disability — Based on Qualitative Research on Medical Treatment Context [J]. Information Resources Work, 2025(04): 36-44.

[20] Xie Xiaqin. A Better Life: The Practical Logic of Urban Digital Governance — Based on the Observations of Chengdu [J]. Exploration, 2024(01): 90-102.

[21] Zhang Xiaohan, Wang Wei. The Impact of Digital Divide on the Quality of Life of the Elderly — The Mediating Role of Intergenerational Support [J]. Southern Population, 2025(01): 22-33.

[22] Zheng Lei. The Content, Path and Direction of Urban Digital Transformation [J]. Exploration and Controversy, 2021(04): 147-152.