JMIR Publications

ABSTRACT

Background:

The COVID-19 pandemic accelerated the adoption of telemedicine in Poland, transforming it into an important component of healthcare delivery. However, despite technological progress and widespread internet access, significant disparities in digital literacy and infrastructure have raised concerns about unequal access to e-health services, particularly among older and rural populations.

Objective:

This study aimed to characterize the patterns of telemedicine use among Polish adults in the post-pandemic era. It sought to identify key sociodemographic and health-related predictors of e-health service adoption to better understand and address digital inequalities in healthcare access.

Methods:

This cross-sectional study analyzed data from the National Test for Poles’ Health, a large-scale annual online survey. We analyzed responses from 1,196,102 Polish adults collected between 2020 and 2024. Telemedicine usage data were available for 820,000 participants. Logistic regression models were used to identify predictors for the use of 12 different telemedicine and e-health services.

Results:

Significant sociodemographic disparities in telemedicine adoption were found. While nearly half of participants used at least one form of telemedicine in the past year, usage was strongly predicted by higher education, urban residence, and chronic diseases. For instance, residents of large cities (>500k) had higher odds of general telemedicine use compared to residents of medium-sized towns (OR 1.5, 95% CI 1.5-1.6). Higher education was a powerful predictor for advanced tools; individuals with a master's degree were more than twice as likely to use the Internet Patient Account compared to those with secondary education (OR 2.2, 95% CI 2.1-2.2).

Conclusions:

Telemedicine in Poland currently mirrors existing socioeconomic divides rather than bridging them. To prevent a permanent digital health chasm, policymakers must move beyond universal access and implement targeted interventions, including community-based digital literacy programs for older adults and infrastructure investment in rural areas, ensuring hybrid models of care remain available. Clinical Trial: The research protocol for this survey-based study, which involved the collection of anonymized data and voluntary participation, was reviewed by the Bioethics Committee of the Military Chamber of Physicians (Wojskowa Izba Lekarska) in Warsaw, Poland. The committee determined that formal ethical approval was not required for this type of study, given its anonymized and voluntary nature (decision no. KB 65/2024).