Saulsberry Loren, Price Mary, Hsu John
Harvard University-Cambridge, Massachusetts.
Massachusetts General Hospital-Mongan Institute for Health Policy.
Medicare Medicaid Res Rev. 2014 Oct 21;4(4). doi: 10.5600/mmrr.004.04.b01. eCollection 2014.
Examine use of the Internet (eHealth) and mobile health (mHealth) technologies by privately insured, publicly insured (Medicare/Medicaid), or uninsured U.S. adults in 2012.
Pew Charitable Trust telephone interviews of a nationally representative, random sample of 3,014 adult U.S. residents, age 18+.
Estimate health information seeking behavior overall and by segment (i.e., insurance type), then, adjust estimates for individual traits, clinical need, and technology access using logistic regression.
Most respondents prefer offline to online (Internet) health information sources; over half across all segments use the Internet. More respondents communicate with providers offline compared with online. Most self-reported Internet users use online tools for health information, with privately insured respondents more likely to use new technologies. Unadjusted use rates differ across segments. Medicaid beneficiaries are more likely than the privately insured to share health information online, and Medicare beneficiaries are more likely than the privately insured to text with health professionals. After adjustment, these differences were minimal (e.g., Medicare beneficiaries had odds similar to the privately insured of online physician consultations), or the direction of the association reversed (e.g., Medicaid beneficiaries had greater odds than the privately insured of online physician consultations versus lower odds before adjustment).
Few adults report eHealth or mHealth use in 2012. Use levels appear unevenly distributed across insurance types, which could be mostly attributed to differences in individual traits and/or need. As out-of-pocket costs of medical care increases, consumers may increasingly turn to these generally free electronic health tools.
研究2012年美国有私人保险、公共保险(医疗保险/医疗补助)或无保险的成年人对互联网(电子健康)和移动健康(移动医疗)技术的使用情况。
皮尤慈善信托基金对3014名年龄在18岁及以上的美国成年居民进行的具有全国代表性的随机电话访谈。
总体上以及按细分群体(即保险类型)估计健康信息搜索行为,然后使用逻辑回归对个体特征、临床需求和技术获取情况进行估计调整。
大多数受访者更喜欢线下而非线上(互联网)健康信息来源;所有细分群体中超过一半的人使用互联网。与线上相比,更多受访者与医疗服务提供者进行线下沟通。大多数自称使用互联网的用户使用在线工具获取健康信息,有私人保险的受访者更有可能使用新技术。未经调整的使用率在各细分群体中存在差异。医疗补助受益人比有私人保险的人更有可能在网上分享健康信息,医疗保险受益人比有私人保险的人更有可能与医疗专业人员发短信。调整后,这些差异很小(例如,医疗保险受益人与有私人保险的人进行在线医生咨询的几率相似),或者关联方向发生了逆转(例如,医疗补助受益人进行在线医生咨询的几率比有私人保险的人更高,而在调整前几率更低)。
2012年很少有成年人报告使用电子健康或移动医疗。使用水平在不同保险类型中分布不均,这可能主要归因于个体特征和/或需求的差异。随着医疗保健自付费用的增加,消费者可能会越来越多地转向这些通常免费的电子健康工具。