School of Economics, University of New South Wales, Level 4, Australian School of Business Building, UNSW Sydney NSW 2052, Australia.
Soc Sci Med. 2012 Nov;75(10):1828-35. doi: 10.1016/j.socscimed.2012.07.022. Epub 2012 Aug 1.
The emergence of the Internet made health information, which previously was almost exclusively available to health professionals, accessible to the general public. Access to health information on the Internet is likely to affect individuals' health care related decisions. The aim of this analysis is to determine how health information that people obtain from the Internet affects their demand for health care. I use a novel data set, the U.S. Health Information National Trends Survey (2003-07), to answer this question. The causal variable of interest is a binary variable that indicates whether or not an individual has recently searched for health information on the Internet. Health care utilization is measured by an individual's number of visits to a health professional in the past 12 months. An individual's decision to use the Internet to search for health information is likely to be correlated to other variables that can also affect his/her demand for health care. To separate the effect of Internet health information from other confounding variables, I control for a number of individual characteristics and use the instrumental variable estimation method. As an instrument for Internet health information, I use U.S. state telecommunication regulations that are shown to affect the supply of Internet services. I find that searching for health information on the Internet has a positive, relatively large, and statistically significant effect on an individual's demand for health care. This effect is larger for the individuals who search for health information online more frequently and people who have health care coverage. Among cancer patients, the effect of Internet health information seeking on health professional visits varies by how long ago they were diagnosed with cancer. Thus, the Internet is found to be a complement to formal health care rather than a substitute for health professional services.
互联网的出现使以前几乎仅向卫生专业人员提供的健康信息面向公众开放。人们获取互联网上的健康信息可能会影响他们的医疗保健相关决策。本分析旨在确定人们从互联网上获取的健康信息如何影响他们对医疗保健的需求。我使用了一个新颖的数据集,即美国健康信息国家趋势调查(2003-07 年),来回答这个问题。感兴趣的因果变量是一个二进制变量,用于指示个体最近是否在互联网上搜索过健康信息。医疗保健利用率由个体在过去 12 个月内访问医疗保健专业人员的次数来衡量。个体决定使用互联网搜索健康信息的行为可能与其他也会影响其医疗保健需求的变量相关。为了将互联网健康信息的影响与其他混杂变量分开,我控制了许多个体特征并使用了工具变量估计方法。作为互联网健康信息的工具变量,我使用了美国各州的电信法规,这些法规被证明会影响互联网服务的供应。我发现,在互联网上搜索健康信息对个人对医疗保健的需求有积极的、相对较大的和具有统计学意义的影响。对于那些更频繁在网上搜索健康信息的个体以及有医疗保险的人来说,这种影响更大。在癌症患者中,互联网健康信息搜索对看医生的影响因他们被诊断出癌症的时间长短而异。因此,互联网被发现是对正规医疗保健的补充,而不是对医疗专业服务的替代。