BackgroundAlthough the use of the Internet for health purposes has increased steadily in the last decade, only a few studies have explored the information provided by the websites of health institutions and no studies on the on-line activities of Italian hospitals have been performed to date. The aim of this study was to explore the characteristics of the contents and the user-orientation of Italian hospital websites.MethodsThe cross-sectional analysis considered all the Italian hospitals with a working website between December 2008 and February 2009. The websites were coded using an ad hoc Codebook, comprising eighty-nine items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. We calculated a website evaluation score, on the basis of the items satisfied, to compare private (PrHs) and public hospitals, the latter divided into ones with their own website (PubHs-1) and ones with a section on the website of their Local Health Authority (PubHs-2). Lastly, a descriptive analysis of each item was carried out.ResultsOut of the 1265 hospitals in Italy, we found that 419 of the 652 public hospitals (64.3%) and 344 of the 613 PrHs (56.1%) had a working website (p = 0.01). The mean website evaluation score was 41.9 for PubHs-1, 21.2 for PubHs-2 and 30.8 for PrHs (p < 0.001).Only 5 hospitals out of 763 (< 1%) provided specific clinical performance indicators, such as the nosocomial infection rate or the surgical mortality rates. Regarding interactive on-line services, although nearly 80% of both public and private hospitals enabled users to communicate on-line, less than 18% allowed the reservation of medical services, and only 8 websites (1%) provided a health-care forum.ConclusionsA high percentage of hospitals did not provide an official website and the majority of the websites found had several limitations. Very few hospitals provided information to increase the credibility of the hospital and user confidence in the institution. This study suggests that Italian hospital websites are more a source of information on admissions and services than a means of communication between user and hospital.

Our results show that OPs advertise their products in an argumentative fashion that enhances consumers' peripheral reflection: by analogically playing with the selling of other commodities, they magnify aspects of the online trade that consumers might find convenient, but overshadow the nature and risks of the actual products they sell.

Internet and e-commerce have deeply changed society, the economy, and the world of health care.

Many online pharmacies that serve as a substitute for original or personal medical prescriptions use a health questionnaire for consumers to complete on their Web site for buying prescription-only medicines. A content analysis of online medical questionnaires from a sample of online pharmacies (OPs) examined their completeness. Fifty-seven questionnaires were identified in which online pharmacies sought health status assessment from online purchasers. To evaluate the questionnaires, a checklist tallied their characteristics, including general features, medical history requested, and involvement of the consumer's doctor. Drug allergies were queried in 55 OPs (96.5%) and other allergies in 40 (70.2%). All of the questionnaires asked whether the consumer had suffered or was currently suffering from a particular illness, but a question about past surgery was present in 23 sites (40.3%) only; 40 sites (70.2%) asked women if they were pregnant or breastfeeding. Only 30 pharmacies out of 57 (52.6%) asked if the consumer's family doctor was aware of his/her intention of buying online and an even lower percentage (19.3%) asked if the purchase was based on a medical diagnosis rendered by a physician. Less than 20% of the pharmacies asked for the name, address, or telephone number of the consumer's family doctor. The results confirm the inadequacy of online pharmacy medical questionnaires in the assessment of health status for prescribing drugs. The results suggest that these questionnaires aim more at giving the consumer a false sense of health assurance than performing an effective assessment of his or her health status relative to the drug purchase.

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