Internet-Based Healthcare Services Use Patterns and Barriers Among Middle-Aged and Older Adults in China: A Cross-Sectional Study

Background The rapid aging of the global population has intensified chronic disease burdens, widened healthcare access disparities, and increased unmet care needs. Internet‑based healthcare services (IHS) offer a potential solution to these challenges. This study assessed the prevalence of IHS use, its key determinants, and the main motivations and barriers among adults aged ≥ 50 years in mainland China. Methods An online survey of adults aged ≥ 50 years in mainland China was conducted in March 2021. Participants (N = 500) were recruited via an automated random‑sampling procedure on an online platform. Logistic regression models were used to examine predisposing, need, and enabling factors associated with IHS use. Results Only 17.14% of respondents reported using IHS, with online medical consultation being the most common (38.5%). Respondents aged between 50 and 59 years (AOR = 4,975 [95% CI 1.224–19.608]), urban residents (AOR = 6.056 [95% CI 1.689–21.713]), higher income (AOR = 3.862 [95% CI 1.822–8.186]), chronic conditions (AOR = 5.323 [95% CI 2.866–9.888]), delays in seeking healthcare (AOR = 5.323 [95% CI 2.866–9.888]), mobility difficulties (AOR = 9.802 [95% CI 4.005–23.993]), positive attitude (AOR = 3.038 [95% CI 1.039–8.884]) were more likely to use IHS, after adjusting for variations in other variables. The primary barriers were distrust and ambiguity in self-described symptoms. Conclusion Low levels of IHS use were observed among middle-aged and elderly populations in mainland China. Although IHS can benefit individuals with high healthcare needs or mobility challenges, income-related and urban-rural inequalities in IHS use persist. Addressing trust issues and enhancing digital literacy among the elderly are essential for the widespread and effective development of IHS.