Gaps between self-reported and documented use of a healthcare service portal among older adults; a cross-sectional survey and retrospective electronic data study
ABSTRACT
Background:
Healthcare systems increasingly offer citizens services through online portals, which have been found to be associated with patient satisfaction and better management of health concerns. Few studies compared reported use to actual use of portals, especially among older adults.
Objective:
Examine differences between actual and self-reported health portal usage, and their association with background variables and digital health literacy among older adults.
Methods:
A cross- sectional telephone survey was conducted among 600 participants aged 60+ who were sampled from a registry of members of a national health maintenance organization (HMO). The participants reported their usage of the HMO’s portal, their digital health literacy (DHL), demographic and background variables. Participants’ actual usage of the portal was retrospectively retrieved from the HMO’s database.
Results:
A large gap between self-reported use and actual use of the health portal was found: for example, while only 8.1% reported not using the portal, HMO’s records indicated 62.0% did not make use of the portal; still, a positive correlation was found between self-reported usage and actual usage (r=.22, P <0.001). Significant strong associations were found between administrative and physician-related online activities, both reported (r=.41, P <0.001) and actual (r=.56, P <0.001). A multivariate analysis where actual use was the dependent variable explained 12.6% of the variance. Age (β=-.09, P=0.038), experience with computers (β=.14, P=0.019), and ethnicity β=-.22, P<0.001) were significantly associated with actual use. DHL, though significantly associated with actual use at bi-variate level (r=.09, P=042), was not significantly associated with actual use in this analysis (β=.02, P=0.999).
Conclusions:
The findings indicate that users tend to overestimate their health portal usage, possibly reflecting social desirability regarding digital functioning or a perception that assisted use is also usage. Future studies on digital health use should also include measures of actual use. Clinical Trial: not a trial
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