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. 2020 Aug 11;22(8):e19013.
doi: 10.2196/19013.

Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study

Zsombor Zrubka  1   2 , Óscar Brito Fernandes  1   3 , Petra Baji  1 , Ottó Hajdu  4 , Levente Kovacs  5 , Dionne Kringos  3 , Niek Klazinga  3 , László Gulácsi  1   2 , Valentin Brodszky  1 , Fanni Rencz  1   6 , Márta Péntek  1
Affiliations

Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study

Zsombor Zrubka et al. J Med Internet Res. .

Abstract

Background: Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care.

Objective: The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary.

Methods: In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal-Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models.

Results: From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals' (HCPs') explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs' explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models).

Conclusions: We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.

Keywords: Hungary; ambulatory care; eHealth literacy, patient-reported experience measures; health literacy; patient-reported outcome measures; shared decision making; survey.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Problem score by eHEALS (eHealth Literacy Scale) quartiles.
Figure 2
Figure 2
Negative Experiences Score by eHEALS (eHealth Literacy Scale) quartiles.
Figure 3
Figure 3
Perceived easiness of understanding the explanations of the health care professional by eHEALS (eHealth Literacy Scale) quartiles.
Figure 4
Figure 4
Perceived involvement of the respondent by the health care professional in decisions about care and treatment by eHEALS (eHealth Literacy Scale) quartiles.
Figure 5
Figure 5
Mean overall quality of the last visit by eHEALS (eHealth Literacy Scale) quartiles.
Figure 6
Figure 6
Overall quality categories of the last visit by eHEALS (eHealth Literacy Scale) quartiles.
See this image and copyright information in PMC

References

    1. Institute of Medicine . Crossing the Quality Chasm: A New Health System for the 21 Century. Washington, DC: Institute of Medicine; 2005. - PubMed
    1. Jo Delaney L. Patient-centred care as an approach to improving health care in Australia. Collegian. 2018 Feb;25(1):119–123. doi: 10.1016/j.colegn.2017.02.005. - DOI
    1. Boncz I, Sebestyén A. Financial deficits in the health services of the UK and Hungary. Lancet. 2006 Sep 09;368(9539):917–8. doi: 10.1016/S0140-6736(06)69369-0. - DOI - PubMed
    1. Tsevat J, Moriates C. Value-Based Health Care Meets Cost-Effectiveness Analysis. Ann Intern Med. 2018 Sep 04;169(5):329–332. doi: 10.7326/M18-0342. - DOI - PubMed
    1. Expert Panel on Effective Ways of Investing in Health (EXPH) Opinion on defining value in “value-based healthcare”. 2019. [2020-07-28]. https://ec.europa.eu/health/expert_panel/sites/expertpanel/files/024_val....

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