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

Hsu, J.

doi:10.1197/jamia.m1672

Cited by 214Health Literacy and Information AccessibilityTelemedicine and Telehealth ImplementationElectronic Health Records Systems

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

Open access

Hsu, J.·2004·Journal of the American Medical Informatics Association

DOI 10.1197/jamia.m1672PMC PMC551548

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Abstract

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.

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Authors: Hsu, J.
Affiliations: United States Department of Veterans Affairs (US)
Corresponding author: Hsu, J.
ORCID: Hsu, J.
Venue: Journal of the American Medical Informatics Association
Publisher: Oxford University Press (OUP)
Published: 2004-11-23
Volume: 12
Issue: 2
Pages: 164-171
ISSN: 1067-5027 (ISSN-L)
1527-974X
DOI: 10.1197/jamia.m1672
PMC: PMC551548
OpenAlex: W2161766695
Cited by: 214
References: 25
Citations by year: 2026: 1 · 2025: 3 · 2024: 11 · 2023: 3 · 2022: 4 · 2021: 11 · 2020: 11 · 2019: 11 · 2018: 6 · 2017: 10 · 2016: 8 · 2015: 17 · 2014: 13 · 2013: 12 · 2012: 14
FWCI: 19.24
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Journal of the American Medical Informatics Association (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Keywords: e-health services, digital divide, health disparities, racial and ethnic disparities, socioeconomic status, online appointment booking, health information technology
MeSH terms: Adolescent, Adult, Aged, California, Child, Child, Preschool, Humans, Infant, Longitudinal Studies, Middle Aged, Socioeconomic Factors, Prepaid Health Plans, Telemedicine, Delivery of Health Care, Integrated, Internet, Racial Groups

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

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