Digital Health Use Across Socioeconomic Groups Among Patients With Chronic Diseases: A Cross-Sectional Study.

IntroductionPeople with a low socio-economic position (SEP) are disproportionally affected by both chronic diseases and with reduced access to, use of, and perceived benefits from e-health. People with one or more chronic diseases are likely to experience a greater burden of disease and have more frequent interactions with the healthcare system and e-health. This study provides insights in whether socio-economic differences in e-health use exist in a Dutch population of people with one or more chronic diseases.MethodsIn 2023 a questionnaire was sent out to 2,113 members of a Dutch panel consisting of people with one or more chronic diseases. Participants were asked about the use of five e-health applications and their inclination to use e-health. E-health applications included: websites, apps, wearables, patient portal and digital communication. Educational attainment was used as a proxy for SEP. Results were stratified by level of educational attainment.ResultsThe response rate was 1,543/2,113, 73%, the final study sample was 1,517. Results show that participants with a lower educational attainment used significantly less websites (OR 4.78, 95% CI, 3.50-6.53), apps (OR 2.88, 95% CI, 2.00-4.16), wearables (OR 2.12, 95% CI, 1.52-2.95) and patient portals (OR 3.24, 95% CI, 2.38-4.41) compared to higher educational attainment groups. Participants with a high educational attainment were more likely to be inclined (RRR 2.21, 95% CI 1,48-3,31) and less likely to be uncertain about e-health use (RRR 0.56, 95% CI 0,39-0.81) compared to participants with a low educational attainment.ConclusionDifferences in e-health use and positive inclination towards e-health use also exist between socio-economic groups in a population of people with a chronic disease. These findings show that current practice and implementation of e-health for people with chronic disease does not serve all patients equally, demanding more attention towards inclusive organization of e-health.