The Journal of Grey System ›› 2025, Vol. 37 ›› Issue (4): 106-118.

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The Assessment of Barriers to Access eHealth Services for Elderly Persons with Disabilities Based on Hybrid Multi-Criteria Decision-Making Models

  

  1. 1. Business School, Qingdao University, Qingdao, Shandong, 266061, P.R. China
    2. Institute for Grey Systems Studies , Nanjing University of Aeronautics and Astronautics, Nanjing, Nanjing, Jiangsu, 211106, P.R. China
    3. Center of Grey System Studies, Northwestern Polytechnical University, Xi'an, Shaanxi, 710129, P.R. China
    4. Jinshen College, Nanjing Audit University, Nanjing, Jiangsu, 210023, P.R. China
  • Online:2025-08-15 Published:2025-07-31
  • Supported by:
    This work was supported by projects of the National Natural Science Foundation of China (72471118，72401132，
    72271124, 52232014, 72071111). It is also partially supported by China Postdoctoral Science Foundation (2022M721596),
    Natural Science Foundation of Jiangsu Province (BK20230870), and Social Science Foundation of Jiangsu Province (23GLC001). At the same time, the authors would like to acknowledge the partial support of the Fundamental Research Funds for the Central Universities (NS2023043).

Abstract:

Providing eHealth services to elderly individuals with disabilities has become a critical global issue, especially in Pakistan, where
access to these services often presents significant barriers that need to be identified and explored to ensure equitable and effective
healthcare delivery. Therefore, this study aimed to identify and rank the barriers to access eHealth services for Pakistani disabled
elderly. A survey was conducted to collect primary data, and 322 elderly people with disabilities provided their consent about facing
barriers to eHealth services. The questionnaire was based on technological, individual, relational, environmental, and organizational constructs. Multiple-criteria Decision-making (MCDM)-based Dynamic Grey Relational Analysis (DGRA) and Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) were applied to explore and rank the significant barriers. We found the barrier “fear and dislike of technology” to be the top-ranked barrier evaluated from both DGRA and TOPSIS techniques. The Kruskal-Wallis (KW) test was also performed to assess the significance of this barrier for the three age groups of disabled elderly and found no significant differences among their age groups when aged ≥ 60 years. In Pakistan, this study is the first to use the DGRA, TOPSIS, and KW tests to examine the rank and significance of barriers to access eHealth services for the disabled elderly.