澳大利亚区域内获得电子健康服务的决定因素。

Determinants of access to eHealth services in regional Australia.

机构信息

School of Commerce, and Centre for Health Research, University of Southern Queensland, QLD 4350, Australia.

出版信息

Int J Med Inform. 2019 Nov;131:103960. doi: 10.1016/j.ijmedinf.2019.103960. Epub 2019 Sep 4.

DOI:10.1016/j.ijmedinf.2019.103960

PMID:31518858

Abstract

BACKGROUND

Australia has a universal public healthcare system, but access to eHealth services (i.e. use of the Internet and related technologies for healthcare services) remains a remarkable challenge, particularly in regional, rural and remote communities. Similar to many other countries, Australia faces the challenges of an ageing population and chronic disease management as well as balancing the supply of and the demand for quality healthcare and advanced medical procedures. The prima facie case for inequality in accessing eHealth services across geographical settings is widely acknowledged. However, regional residents' perceptions on access to eHealth services lack empirical evidence. Therefore, this study empirically investigates the current state and predictors of eHealth service access in regional Australia.

METHODS

A cross-sectional questionnaire-based household survey was conducted within a total of 390 randomly selected adults from the Western Downs Region in Southeast Queensland, Australia. Bivariate analysis was conducted to examine the relationship between eHealth access and respondents' characteristics. A multivariate logistic regression model was also performed to identify the significant predictors of eHealth service access in regional Australia.

RESULTS

Approximately 78% of the households have access to eHealth services. However, access to eHealth services in socioeconomically disadvantaged households was lower (19%) than that of their advantaged counterparts (25%). Factors that significantly increased the likelihood of accessing eHealth services included middle age (odds ratio [OR] = 2.75, 95% confidence interval [CI]: 1.84, 8.66), household size (three to four members) (OR = 2.29, 95% CI: 1.19, 4.73), broadband Internet access (OR = 1.67, 95% CI: 1.15, 2.90) and digital literacy (OR = 2.39, 95% CI: 1.23, 4.59). Factors that negatively influenced access to eHealth services were low educational levels (OR = 0.28, 95% CI: 0.09, 0.61), low socioeconomic status (OR = 0.65, 95% CI: 0.28, 0.83) and remote locations (OR = 0.66, 95% CI: 0.23, 0.80).

CONCLUSION

Emerging universal eHealth access provides immense societal benefits in regional settings. The findings of this study could assist policy makers and healthcare practitioners in identifying factors that influence eHealth access and thereby formulate effective health policies to optimise healthcare utilisation in regional Australia.

摘要

背景

澳大利亚拥有全民公共医疗体系，但电子医疗服务（即利用互联网和相关技术提供医疗服务）的获取仍然是一个巨大的挑战，尤其是在地区、农村和偏远社区。与许多其他国家一样，澳大利亚面临着人口老龄化和慢性病管理的挑战，同时还需要平衡医疗保健和先进医疗程序的供给与需求。在地理环境中获取电子医疗服务存在不平等的现象是显而易见的。然而，地区居民对获取电子医疗服务的看法缺乏实证证据。因此，本研究从实证角度调查了澳大利亚地区电子医疗服务获取的现状和预测因素。

方法

在澳大利亚昆士兰州东南部西部唐斯地区的 390 名随机选择的成年人中进行了一项基于横断面问卷调查的家庭调查。对电子医疗服务获取与受访者特征之间的关系进行了双变量分析。还进行了多变量逻辑回归模型，以确定澳大利亚地区电子医疗服务获取的显著预测因素。

结果

约有 78%的家庭能够获得电子医疗服务。然而，在社会经济地位处于劣势的家庭中，获得电子医疗服务的比例（19%）低于其优势家庭（25%）。显著增加获得电子医疗服务可能性的因素包括中年（优势比 [OR] = 2.75，95%置信区间 [CI]：1.84，8.66）、家庭规模（三到四人）（OR = 2.29，95% CI：1.19，4.73）、宽带互联网接入（OR = 1.67，95% CI：1.15，2.90）和数字素养（OR = 2.39，95% CI：1.23，4.59）。对电子医疗服务获取有负面影响的因素包括低教育水平（OR = 0.28，95% CI：0.09，0.61）、低社会经济地位（OR = 0.65，95% CI：0.28，0.83）和偏远地区（OR = 0.66，95% CI：0.23，0.80）。