A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions

Mariusz Duplaga

Provision of care to patients with chronic diseases remains a great challenge for modern health care systems. eHealth is indicated as one of the strategies which could improve care delivery to this group of patients. The main objective of this study was to assess determinants of the acceptance of the Internet use for provision of chosen health care services remaining in the scope of current nationwide eHealth initiative in Poland. The survey was carried out among patients with diagnosed chronic conditions who were treated in three health care facilities in Krakow, Poland. Survey data was used to develop univariate and multivariate logistic regression models for six outcome variables originating from the items assessing the acceptance of specific types of eHealth applications. The variables used as predictors were related to the sociodemographic characteristics of respondents, burden related to chronic disease, and the use of the Internet and its perceived usefulness in making personal health-related decisions. Among 395 respondents, there were 60.3% of Internet users. Univariate logistic regression models developed for six types of eHealth solutions demonstrated their higher acceptance among younger respondents, living in urban areas, who have attained a higher level of education, used the Internet on their own, and were more confident about its usefulness in making health-related decisions. Furthermore, the duration of chronic disease and hospitalization due to chronic disease predicted the acceptance of some of eHealth applications. However, when combined in multivariate models, only the belief in the usefulness of the Internet (five of six models), level of education (four of six models), and previous hospitalization due to chronic disease (three of six models) maintained the effect on the independent variables. The perception of the usefulness of the Internet in making health-related decision is a key determinant of the acceptance of provision of health care services online among patients with chronic diseases. Among sociodemographic factors, only the level of education demonstrates a consistent impact on the level of acceptance. Interestingly, a greater burden of chronic disease related to previous hospitalizations leads to lower acceptance of eHealth solutions.