JMIR Publications

ABSTRACT

Background:

Disparities in Internet medical services utilization for patients marginalize vulnerable groups from digital health benefits. While these disparities were not understood during the post COVID pandemic period in China.

Objective:

This study aimed to identify the disparities which limit Internet medical services utilization for Chinese adult patients, then provide key reference points for digital health-related policies.

Methods:

Data were obtained from the 2023 provincial field survey that included Jiangsu adult outpatients, and the 2024 national online survey that included Chinese adults with outpatient records in the past 3 months. A descriptive and comparative analysis for status, patterns, and preferences of Internet medical services utilization. Binary logistic regression model assessed patient characteristics associated with the status of Internet medical services utilization.

Results:

Of 2,011 patients in the Jiangsu field survey, 39.43% reported using Internet medical services at least once in previous 12 months. The status of Internet medical services utilization was associated with partial patient characteristics significantly. For example, patients aged below 60 years were more likely to access Internet medical services than aged over 60 years (odds ratio [OR] 1.54, 95% CI 1.07-2.21, P=.02). For the patterns, patients were trapped in shallow Internet medical services (e.g., minor disease was the most primary reason with 55.93%). Vulnerable patients such as geriatrics aged over 60 years without medical insurance were less likely to prefer higher-price internet medical services (median score 1 point). Of 1,611 patients in the national online survey, all patients reported accessing Internet medical services in previous 12 months. The status of Internet medical services utilization was partial associated with patient characteristics significantly. For instance, patients in very-unhealth status were more likely to access Internet medical services than in health status (OR 4.19, 95% CI 1.36-12.95, P=.01). For the patterns, patients were trapped in shallow Internet medical services (e.g., minor disease was one domain primary reason with 28.38%). Uninsured patients aged below 60 years were less likely to prefer higher-price Internet medical services (median score 2 point).

Conclusions:

Disparities maintained in status, patterns, and preferences of Internet medical services utilization among Chinese adult patients after the COVID-19 pandemic. More pro-vulnerable patients policies may be warranted for narrowing Internet medical services utilization disparities to ensure digital health equity in China.