Quantifying digital health inequality across a national healthcare system.

IF 4.1 Q1 HEALTH CARE SCIENCES & SERVICES
Joe Zhang, Jack Gallifant, Robin L Pierce, Aoife Fordham, James Teo, Leo Celi, Hutan Ashrafian
{"title":"Quantifying digital health inequality across a national healthcare system.","authors":"Joe Zhang, Jack Gallifant, Robin L Pierce, Aoife Fordham, James Teo, Leo Celi, Hutan Ashrafian","doi":"10.1136/bmjhci-2023-100809","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary care services, allows measurement of digital inequality across a nation. We aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England.</p><p><strong>Methods: </strong>We used multivariable regression to test association of population and provider characteristics (including patient demographics, socioeconomic deprivation, disease burden, prescribing burden, geography and healthcare provider resource) with activation of two independent digital services during 2021/2022.</p><p><strong>Results: </strong>We find a significant adjusted association between increased population deprivation and reduced digital utilisation across both interventions. Multivariable regression coefficients for most deprived quintiles correspond to 4.27 million patients across England where deprivation is associated with non-activation of the NHS App.</p><p><strong>Conclusion: </strong>Results are concerning for technologically driven widening of healthcare inequalities. Targeted incentive to digital is necessary to prevent digital disparity from becoming health outcomes disparity.</p>","PeriodicalId":9050,"journal":{"name":"BMJ Health & Care Informatics","volume":null,"pages":null},"PeriodicalIF":4.1000,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10680008/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Health & Care Informatics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1136/bmjhci-2023-100809","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary care services, allows measurement of digital inequality across a nation. We aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England.

Methods: We used multivariable regression to test association of population and provider characteristics (including patient demographics, socioeconomic deprivation, disease burden, prescribing burden, geography and healthcare provider resource) with activation of two independent digital services during 2021/2022.

Results: We find a significant adjusted association between increased population deprivation and reduced digital utilisation across both interventions. Multivariable regression coefficients for most deprived quintiles correspond to 4.27 million patients across England where deprivation is associated with non-activation of the NHS App.

Conclusion: Results are concerning for technologically driven widening of healthcare inequalities. Targeted incentive to digital is necessary to prevent digital disparity from becoming health outcomes disparity.

量化全国医疗保健系统中的数字健康不平等。
目标:数字健康不平等,被观察为不同人群对数字工具的不同利用,以前在国家卫生服务(NHS)中没有被量化。部署普遍的数字卫生干预措施,包括全国智能手机应用程序和在线初级保健服务,可以衡量全国范围内的数字不平等。我们的目标是测量与6356名初级保健提供者为英格兰人口服务的数字利用相关的人口因素。方法:我们使用多变量回归来检验2021/2022年期间人口和提供者特征(包括患者人口统计学、社会经济剥夺、疾病负担、处方负担、地理和医疗保健提供者资源)与两个独立数字服务的激活之间的关联。结果:我们发现在两种干预措施中,人口剥夺增加和数字利用减少之间存在显著的调整关联。大多数贫困五分之一的多变量回归系数对应于整个英格兰的427万患者,其中剥夺与未激活NHS应用程序有关。结论:结果涉及技术驱动的医疗不平等扩大。有针对性的数字激励是必要的,以防止数字差距成为健康结果的差距。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.10
自引率
4.90%
发文量
40
审稿时长
18 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信