电子健康素养与英格兰 NHS111 在线紧急护理服务的使用：横断面调查。

eHealth Literacy and the Use of NHS 111 Online Urgent Care Service in England: Cross-Sectional Survey.

机构信息

School of Health Sciences, University of Southampton, Southampton, United Kingdom.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.

出版信息

J Med Internet Res. 2024 Jun 4;26:e50376. doi: 10.2196/50376.

DOI:10.2196/50376

PMID:38833297

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11185907/

Abstract

BACKGROUND

Many health care systems have used digital technologies to support care delivery, a trend amplified by the COVID-19 pandemic. "Digital first" may exacerbate health inequalities due to variations in eHealth literacy. The relationship between eHealth literacy and web-based urgent care service use is unknown.

OBJECTIVE

This study aims to measure the association between eHealth literacy and the use of NHS (National Health Service) 111 online urgent care service.

METHODS

A cross-sectional sequential convenience sample survey was conducted with 2754 adults (October 2020-July 2021) from primary, urgent, or emergency care; third sector organizations; and the NHS 111 online website. The survey included the eHealth Literacy Questionnaire (eHLQ), questions about use, preferences for using NHS 111 online, and sociodemographic characteristics.

RESULTS

Across almost all dimensions of the eHLQ, NHS 111 online users had higher mean digital literacy scores than nonusers (P<.001). Four eHLQ dimensions were significant predictors of use, and the most highly significant dimensions were eHLQ1 (using technology to process health information) and eHLQ3 (ability to actively engage with digital services), with odds ratios (ORs) of 1.86 (95% CI 1.46-2.38) and 1.51 (95% CI 1.22-1.88), respectively. Respondents reporting a long-term health condition had lower eHLQ scores. People younger than 25 years (OR 3.24, 95% CI 1.87-5.62) and those with formal qualifications (OR 0.74, 95% CI 0.55-0.99) were more likely to use NHS 111 online. Users and nonusers were likely to use NHS 111 online for a range of symptoms, including chest pain symptoms (n=1743, 70.4%) or for illness in children (n=1117, 79%). The users of NHS 111 online were more likely to have also used other health services, particularly the 111 telephone service (χ=138.57; P<.001).

CONCLUSIONS

These differences in eHealth literacy scores amplify perennial concerns about digital exclusion and access to care for those impacted by intersecting forms of disadvantage, including long-term illness. Although many appear willing to use NHS 111 online for a range of health scenarios, indicating broad acceptability, not all are able or likely to do this. Despite a policy ambition for NHS 111 online to substitute for other services, it appears to be used alongside other urgent care services and thus may not reduce demand.

摘要

背景

许多医疗保健系统都使用数字技术来支持医疗服务，这种趋势因 COVID-19 大流行而加剧。“数字优先”可能会由于电子健康素养的差异而加剧健康不平等。电子健康素养与基于网络的紧急护理服务使用之间的关系尚不清楚。

目的

本研究旨在衡量电子健康素养与使用 NHS（国家卫生服务）111 在线紧急护理服务之间的关联。

方法

2020 年 10 月至 2021 年 7 月期间，从初级、紧急或急诊护理、第三部门组织和 NHS 111 在线网站中进行了一项横断面顺序便利样本调查，共调查了 2754 名成年人。调查包括电子健康素养问卷（eHLQ）、使用情况、对使用 NHS 111 在线的偏好以及社会人口特征问题。

结果

在 eHLQ 的几乎所有维度上，NHS 111 在线用户的数字素养平均得分均高于非用户（P<.001）。四个 eHLQ 维度是使用的显著预测因素，最重要的 eHLQ 维度是 eHLQ1（使用技术处理健康信息）和 eHLQ3（主动参与数字服务的能力），优势比（OR）分别为 1.86（95%CI 1.46-2.38）和 1.51（95%CI 1.22-1.88）。报告有长期健康状况的受访者的 eHLQ 得分较低。25 岁以下的人（OR 3.24，95%CI 1.87-5.62）和具有正规学历的人（OR 0.74，95%CI 0.55-0.99）更有可能使用 NHS 111 在线。NHS 111 在线的用户和非用户都可能因一系列症状（包括胸痛症状[n=1743，70.4%]或儿童疾病[n=1117，79%]）使用 NHS 111 在线。使用 NHS 111 在线的用户更有可能也使用过其他卫生服务，特别是 111 电话服务（χ=138.57；P<.001）。

结论

这些电子健康素养得分的差异加剧了人们对数字排斥和弱势群体（包括长期患病者）获得护理的关注。尽管许多人似乎愿意使用 NHS 111 在线处理各种健康状况，表明广泛接受，但并非所有人都能够或愿意这样做。尽管 NHS 111 在线的政策目标是替代其他服务，但它似乎与其他紧急护理服务一起使用，因此可能不会减少需求。