Quantifying digital health inequality across a national healthcare system
Objectives Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-12-01
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| Series: | BMJ Health & Care Informatics |
| Online Access: | https://informatics.bmj.com/content/30/1/e100809.full |
| _version_ | 1797364613849808896 |
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| author | Hutan Ashrafian James Teo Robin L Pierce Joe Zhang Jack Gallifant Leo Celi Aoife Fordham |
| author_facet | Hutan Ashrafian James Teo Robin L Pierce Joe Zhang Jack Gallifant Leo Celi Aoife Fordham |
| author_sort | Hutan Ashrafian |
| collection | DOAJ |
| description | Objectives Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary care services, allows measurement of digital inequality across a nation. We aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England.Methods We used multivariable regression to test association of population and provider characteristics (including patient demographics, socioeconomic deprivation, disease burden, prescribing burden, geography and healthcare provider resource) with activation of two independent digital services during 2021/2022.Results We find a significant adjusted association between increased population deprivation and reduced digital utilisation across both interventions. Multivariable regression coefficients for most deprived quintiles correspond to 4.27 million patients across England where deprivation is associated with non-activation of the NHS App.Conclusion Results are concerning for technologically driven widening of healthcare inequalities. Targeted incentive to digital is necessary to prevent digital disparity from becoming health outcomes disparity. |
| first_indexed | 2024-03-08T16:38:45Z |
| format | Article |
| id | doaj.art-f7769a0d60c349ddbf9a83bd21738d1e |
| institution | Directory Open Access Journal |
| issn | 2632-1009 |
| language | English |
| last_indexed | 2024-03-08T16:38:45Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Health & Care Informatics |
| spelling | doaj.art-f7769a0d60c349ddbf9a83bd21738d1e2024-01-05T12:25:09ZengBMJ Publishing GroupBMJ Health & Care Informatics2632-10092023-12-0130110.1136/bmjhci-2023-100809Quantifying digital health inequality across a national healthcare systemHutan Ashrafian0James Teo1Robin L Pierce2Joe Zhang3Jack Gallifant4Leo Celi5Aoife Fordham6Institute of Global Health Innovation, Imperial College London, London, UKDepartment of Neurology, Kings College Hospital NHS Foundation Trust, London, UKUniversity of Exeter Law School, University of Exeter, Exeter, UKInstitute of Global Health Innovation, Imperial College London, London, UKDepartment of Critical Care, Guy`s and St. Thomas` Hospital, London, UKInstitute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USATransformation Directorate, NHS England, London, UKObjectives Digital health inequality, observed as differential utilisation of digital tools between population groups, has not previously been quantified in the National Health Service (NHS). Deployment of universal digital health interventions, including a national smartphone app and online primary care services, allows measurement of digital inequality across a nation. We aimed to measure population factors associated with digital utilisation across 6356 primary care providers serving the population of England.Methods We used multivariable regression to test association of population and provider characteristics (including patient demographics, socioeconomic deprivation, disease burden, prescribing burden, geography and healthcare provider resource) with activation of two independent digital services during 2021/2022.Results We find a significant adjusted association between increased population deprivation and reduced digital utilisation across both interventions. Multivariable regression coefficients for most deprived quintiles correspond to 4.27 million patients across England where deprivation is associated with non-activation of the NHS App.Conclusion Results are concerning for technologically driven widening of healthcare inequalities. Targeted incentive to digital is necessary to prevent digital disparity from becoming health outcomes disparity.https://informatics.bmj.com/content/30/1/e100809.full |
| spellingShingle | Hutan Ashrafian James Teo Robin L Pierce Joe Zhang Jack Gallifant Leo Celi Aoife Fordham Quantifying digital health inequality across a national healthcare system BMJ Health & Care Informatics |
| title | Quantifying digital health inequality across a national healthcare system |
| title_full | Quantifying digital health inequality across a national healthcare system |
| title_fullStr | Quantifying digital health inequality across a national healthcare system |
| title_full_unstemmed | Quantifying digital health inequality across a national healthcare system |
| title_short | Quantifying digital health inequality across a national healthcare system |
| title_sort | quantifying digital health inequality across a national healthcare system |
| url | https://informatics.bmj.com/content/30/1/e100809.full |
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