JMIR Publications

ABSTRACT

Background:

The number of online services in health care services is increasing rapidly in developed countries. Clients and patients are expected to have a more skilled and active role in taking care of their health and prevention of ill-health. This induces risks that especially those who need the services the most would drop out of digital services resulting in digital divide or exclusion. To ensure wide and equal use of online services it would be important that all clients experience them as beneficial.

Objective:

The present study aimed to examine associations of a) demographics (age, gender, and degree of urbanization), b) self-rated health, c) socioeconomic position (education, experienced financial hardship, labor market position and living alone), d) social participation (voting, satisfaction with relationships and keeping in touch with friends and family members) and e) access, skills and the extent of use of ICT with perceived benefits of online healthcare and social welfare services. The associations were examined separately for perceived health, economic and collaboration benefits.

Methods:

We used a large random sample representative of the Finnish population including 4497 (56.8 % women) respondents aged between 20 and 97. Analyses of covariance were used to examine the associations of independent variables with perceived benefits.

Results:

Access to online services, own ICT skills and the extent of use were associated with all examined benefits of online services. Own ICT skills seemed to be the most important factor. Poor self-rated health was also consistently associated with lower levels of perceived benefits. Similarly, those who were keeping in touch with their friends and relatives at least once a week perceived online services more often beneficial in all the examined dimensions. Those who had experienced financial hardship perceived less health and economic benefits than others. Those who were satisfied with their relationships reported higher levels of health and collaboration benefits compared to their counterparts. Also age, education and degree of urbanization had some statistically significant associations with benefits but they seemed to be, at least partly, explained by differences in access, skills and the extent of use of online services.

Conclusions:

According to our results, online health services have the potential to reinforce existing social and health inequalities. Our findings suggest that access to online services, skills to use them and the extent of use play a crucial role in perceiving them as beneficial. Moreover, it seems that there is a risk of digital exclusion among those who are socioeconomically disadvantaged, suffer from ill-health or are socially isolated. In times when health and social services are increasingly offered online, this digital divide may predispose particularly people with high needs for services to exclusion from them.