Abstract
The rapid growth of the older adult population has brought significant challenges to the medical industry. Problems such as uneven distribution of medical resources, low medical efficiency, and lack of post-hospital care have become prominent. Many hospitals in China use online operating systems and the existing telemedicine service system does not consider the needs, preferences, and characteristics of older adults. Therefore, analyzing the factors that affect older adults' intention to use telemedicine is essential for designing telemedicine service systems. The technology acceptance model (TAM) and emotional design theory were used to build a model of factors influencing older adults' telemedicine use intention in China. This research gathers data via questionnaires and employs structural equation modelling for analysis. A total of 377 participants provided responses regarding telemedicine. The collected data was subsequently analyzed using structural equation modelling. Perceived usefulness and perceived ease of use are the primary drivers affecting the behavioral intention of older adults to use telemedicine, followed by cost value, system quality, trust, and self-efficacy. In contrast, Technological anxiety has an adverse effect on the older adults' intention to use telemedicine. These findings contribute to a validated model that plays a central role in explaining telemedicine adoption among older adults. The model provides actionable insights for policymakers, healthcare providers, and designers to support the development of inclusive service strategies, improve system accessibility, and enhance user-centered design. It also offers a theoretical foundation for future research on sustained digital healthcare engagement in aging populations.