Quantifying digital health inequality across a national healthcare system.

IF 4.1 Q1 HEALTH CARE SCIENCES & SERVICES BMJ Health & Care Informatics Pub Date : 2023-11-24 DOI:10.1136/bmjhci-2023-100809
Joe Zhang, Jack Gallifant, Robin L Pierce, Aoife Fordham, James Teo, Leo Celi, Hutan Ashrafian
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Abstract

Objectives: Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary care services, allows measurement of digital inequality across a nation. We aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England.

Methods: We used multivariable regression to test association of population and provider characteristics (including patient demographics, socioeconomic deprivation, disease burden, prescribing burden, geography and healthcare provider resource) with activation of two independent digital services during 2021/2022.

Results: We find a significant adjusted association between increased population deprivation and reduced digital utilisation across both interventions. Multivariable regression coefficients for most deprived quintiles correspond to 4.27 million patients across England where deprivation is associated with non-activation of the NHS App.

Conclusion: Results are concerning for technologically driven widening of healthcare inequalities. Targeted incentive to digital is necessary to prevent digital disparity from becoming health outcomes disparity.

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量化全国医疗保健系统中的数字健康不平等。
目标:数字健康不平等,被观察为不同人群对数字工具的不同利用,以前在国家卫生服务(NHS)中没有被量化。部署普遍的数字卫生干预措施,包括全国智能手机应用程序和在线初级保健服务,可以衡量全国范围内的数字不平等。我们的目标是测量与6356名初级保健提供者为英格兰人口服务的数字利用相关的人口因素。方法:我们使用多变量回归来检验2021/2022年期间人口和提供者特征(包括患者人口统计学、社会经济剥夺、疾病负担、处方负担、地理和医疗保健提供者资源)与两个独立数字服务的激活之间的关联。结果:我们发现在两种干预措施中,人口剥夺增加和数字利用减少之间存在显著的调整关联。大多数贫困五分之一的多变量回归系数对应于整个英格兰的427万患者,其中剥夺与未激活NHS应用程序有关。结论:结果涉及技术驱动的医疗不平等扩大。有针对性的数字激励是必要的,以防止数字差距成为健康结果的差距。
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来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
期刊最新文献
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