This Article Full Text Full Text (PDF) All Versions of this Article: M1672v1 12/2/164    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hsu, J. Articles by Ortiz, E. Search for Related Content PubMed PubMed Citation Articles by Hsu, J. Articles by Ortiz, E.

Use of e-Health Services between 1999 and 2002: A Growing Digital Divide

Affiliations of the authors: Kaiser Permanente Medical Care Program, Oakland, CA (JHs, JHu, JK, BF, JS); University of California, San Francisco, San Francisco, CA (RM); Veterans Affairs Medical Center, Washington, DC (EO).

Correspondence and reprints: John Hsu, MD, MBA, MSCE, 2000 Broadway, 3rd Floor, Oakland, CA 94612; e-mail: <jth{at}dor.kaiser.org>.

Received for publication: 08/13/04; accepted for publication: 11/01/04.

Objective: To evaluate the patterns of e-Health use over a four-year period and the characteristics of users.

Design: Longitudinal, population-based study (1999–2002) of members of a prepaid integrated delivery system. Available e-Health services included ordering prescription drug refills, scheduling appointments, and asking medical questions.

Measurements: Rates of known access to e-Health services, and of e-Health use each quarter.

Results: The number of members with known e-Health access increased from 51,336 (1.6%) in 1999 to 324,522 (9.3%), in 2002. The percentage of households in which at least one person in the household had access increased from 2.7% to 14.1%. Among the subjects with known access, the percentage of subjects that used e-Health at least once increased from 25.7% in 1999 to 36.2% in 2002. In the multivariate analysis, subjects who had a low expected clinical need, were nonwhite, or lived in low socioeconomic status (SES) neighborhoods were less likely to have used e-Health services in 2002. Disparities by race/ethnicity and SES persisted after controlling for access to e-Health and widened over time.

Conclusion: Access to and use of e-Health services are growing rapidly. Use of these services appears to be greatest among persons with more medical need. The majority of subjects, however, do not use any e-Health services. More research is needed to determine potential reasons for disparities in e-Health use by race/ethnicity and SES as well as the implications of these disparities on clinical outcomes.

This article has been cited by other articles:

				A. Colledge, J. Car, A. Donnelly, and A. Majeed Health information for patients: time to look beyond patient information leaflets J R Soc Med, September 1, 2008; 101(9): 447 - 453. [Full Text] [PDF]

				J. D. Ralston, D. Carrell, R. Reid, M. Anderson, M. Moran, and J. Hereford Patient Web Services Integrated with a Shared Medical Record: Patient Use and Satisfaction J. Am. Med. Inform. Assoc., November 1, 2007; 14(6): 798 - 806. [Abstract] [Full Text] [PDF]

				M. Rahmqvist and A.-C. Bara Patients retrieving additional information via the Internet: A trend analysis in a Swedish population, 2000--05 Scand J Public Health, October 1, 2007; 35(5): 533 - 539. [Abstract] [PDF]