TY - JOUR
T1 - Use of e-Health services between 1999 and 2002
T2 - A growing digital divide
AU - Hsu, John
AU - Huang, Jie
AU - Kinsman, James
AU - Fireman, Bruce
AU - Miller, Robert
AU - Selby, Joseph
AU - Ortiz, Eduardo
PY - 2005/3
Y1 - 2005/3
N2 - To evaluate the patterns of e-Health use over a four-year period and the characteristics of users. 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. Rates of known access to e-Health services, and of e-Health use each quarter. 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. 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.
AB - To evaluate the patterns of e-Health use over a four-year period and the characteristics of users. 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. Rates of known access to e-Health services, and of e-Health use each quarter. 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. 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.
UR - http://www.scopus.com/inward/record.url?scp=14544292448&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=14544292448&partnerID=8YFLogxK
U2 - 10.1197/jamia.M1672
DO - 10.1197/jamia.M1672
M3 - Article
C2 - 15561786
AN - SCOPUS:14544292448
SN - 1067-5027
VL - 12
SP - 164
EP - 171
JO - Journal of the American Medical Informatics Association
JF - Journal of the American Medical Informatics Association
IS - 2
ER -