PDF(Pubmed)
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 (χ12=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.
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 (χ12=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：许多医疗保健系统已经使用数字技术支持护理服务，COVID-19大流行放大了这一趋势。由于电子健康素养的变化，“数字第一”可能会加剧健康不平等。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：对小学的2754名成年人（2020年10月至2021年7月）进行了横断面序贯便利抽样调查，紧急,或紧急护理；第三部门组织；和NHS111在线网站。调查包括电子健康素养问卷(eHLQ)，关于使用的问题，在线使用NHS111的偏好，和社会人口特征。
结果：在eHLQ的几乎所有维度上，NHS111在线用户的平均数字素养得分高于非用户（P<.001）。四个eHLQ维度是使用的重要预测因子，最重要的维度是eHLQ1(使用技术处理健康信息)和eHLQ3(积极参与数字服务的能力)，赔率比(OR)为1.86(95%CI1.46-2.38)和1.51(95%CI1.22-1.88)，分别。报告长期健康状况的受访者的eHLQ得分较低。年龄小于25岁的人（OR3.24，95％CI1.87-5.62）和具有正式资格的人（OR0.74，95％CI0.55-0.99）更有可能在线使用NHS111。用户和非用户可能会在网上使用NHS111治疗一系列症状，包括胸痛症状（n=1743，70.4%）或儿童疾病（n=1117，79%）。NHS111在线用户更有可能使用其他医疗服务，特别是111电话服务(χ12=138.57；P<.001)。
结论：电子健康素养得分的这些差异加剧了人们对数字排斥和受交叉形式不利影响的人获得护理的长期担忧，包括长期的疾病。尽管许多人似乎愿意在一系列健康场景中使用NHS111在线，表明广泛的可接受性，并非所有人都有能力或可能做到这一点。尽管有政策雄心要求NHS111在线替代其他服务，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。
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：对小学的2754名成年人（2020年10月至2021年7月）进行了横断面序贯便利抽样调查，紧急,或紧急护理；第三部门组织；和NHS111在线网站。调查包括电子健康素养问卷(eHLQ)，关于使用的问题，在线使用NHS111的偏好，和社会人口特征。
结果：在eHLQ的几乎所有维度上，NHS111在线用户的平均数字素养得分高于非用户（P<.001）。四个eHLQ维度是使用的重要预测因子，最重要的维度是eHLQ1(使用技术处理健康信息)和eHLQ3(积极参与数字服务的能力)，赔率比(OR)为1.86(95%CI1.46-2.38)和1.51(95%CI1.22-1.88)，分别。报告长期健康状况的受访者的eHLQ得分较低。年龄小于25岁的人（OR3.24，95％CI1.87-5.62）和具有正式资格的人（OR0.74，95％CI0.55-0.99）更有可能在线使用NHS111。用户和非用户可能会在网上使用NHS111治疗一系列症状，包括胸痛症状（n=1743，70.4%）或儿童疾病（n=1117，79%）。NHS111在线用户更有可能使用其他医疗服务，特别是111电话服务(χ12=138.57；P<.001)。
结论：电子健康素养得分的这些差异加剧了人们对数字排斥和受交叉形式不利影响的人获得护理的长期担忧，包括长期的疾病。尽管许多人似乎愿意在一系列健康场景中使用NHS111在线，表明广泛的可接受性，并非所有人都有能力或可能做到这一点。尽管有政策雄心要求NHS111在线替代其他服务，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。
