Access to online health information: Differences by health insurance status

Purpose: To explore the use of internet for health information by insurance status among patients attending community clinics in LA.

Methods: cross-sectional survey with face-to-face interview of a systematic sample of 181 patients who used internet to access health information.

Results: Of the 188 users, 66% were female, 39% were African American and 20% were Hispanics, their median age was 45 years, 40% had income $<25,000, 18% were uninsured. Most subjects reported that their health information was improved by the use of the internet (87%). The majority of the users accessed the internet to look for information related to disease/treatment (92%). They believed the online information was useful (90%), helpful (96%), and helped in making health related decision (89%).

Compared to those with health insurance, uninsured were less frequent users of the internet (42% vs. 68%) and less likely to search the internet for diseases (72% vs. 99%), treatment (56% vs. 87%), drugs (31% vs. 56%), or specific doctor/hospital (13% vs. 51%) (p<0.05). Uninsured were more likely to search the internet for information related to diet/nutrition/exercise relative to insured subjects (88% vs. 71%). Uninsured group were less interested in the provider of the information (21% vs. 38%) or the time of its update (15% vs. 26%) compared to the insured group (p<0.05). Relative to the insured subjects, the uninsured subjects were less likely to talk to the doctors about the online information (55% vs. 76%). The effect of this information on health related factors varied by insurance status. The effect of the information on health related decisions (33% vs. 57%), decision to see or ask questions to a doctor (46% vs. 74%), coping with health problem (27% vs. 45%), or change the overall approach to maintain health (36% vs. 63%) were reported by a lower percentage of the uninsured group relative to the insured group (p<0.05). The perception about the online health information varied significantly by insurance status where higher percentage of the uninsured subjects perceived the usefulness (49% vs. 42%) and the importance (58% vs. 31%) of the online information compared to insured subjects.

Conclusions: Most of the users valued the usefulness of the internet in improving health information and health related decision-making. Insurance status was a contributing factor that affected the patient's utilization of online health information and its effect on health and health care decisions. Health promotion intervention using internet might benefit the population at community clinics.