Changes in general practice use and costs with COVID-19 and telehealth initiatives: analysis of Australian whole-population linked data

Butler, Danielle; Douglas, Kirsty; Sayeed, Muhammad Shahdaat Bin; Welsh, Jennifer; Douglas, Angus; Korda, Rosemary

doi:10.3399/bjgp.2022.0351

Cited by 4 publications

(1 citation statement)

References 24 publications

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“…A rapid review identified challenges with reduced digital access and digital literacy among the older adults and racial and ethnic minority groups, which are both groups at greater health risk from COVID-19 infections [12]. An Australian population study showed that the rapid uptake of telehealth during peak pandemic was not uniform, with the older adults, very young, and those with limited English language proficiency having a lower uptake of general practitioner (GP) telehealth services [13].…”

Section: Our Current Understanding Of the Digital Health Dividementioning

confidence: 99%

Evaluating the Digital Health Experience for Patients in Primary Care: Mixed Methods Study

Choy,

O'Brien,

Barnes

et al. 2024

J Med Internet Res

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Background The digital health divide for socioeconomic disadvantage describes a pattern in which patients considered socioeconomically disadvantaged, who are already marginalized through reduced access to face-to-face health care, are additionally hindered through less access to patient-initiated digital health. A comprehensive understanding of how patients with socioeconomic disadvantage access and experience digital health is essential for improving the digital health divide. Primary care patients, especially those with chronic disease, have experience of the stages of initial help seeking and self-management of their health, which renders them a key demographic for research on patient-initiated digital health access. Objective This study aims to provide comprehensive primary mixed methods data on the patient experience of barriers to digital health access, with a focus on the digital health divide. Methods We applied an exploratory mixed methods design to ensure that our survey was primarily shaped by the experiences of our interviewees. First, we qualitatively explored the experience of digital health for 19 patients with socioeconomic disadvantage and chronic disease and second, we quantitatively measured some of these findings by designing and administering a survey to 487 Australian general practice patients from 24 general practices. Results In our qualitative first phase, the key barriers found to accessing digital health included (1) strong patient preference for human-based health services; (2) low trust in digital health services; (3) high financial costs of necessary tools, maintenance, and repairs; (4) poor publicly available internet access options; (5) reduced capacity to engage due to increased life pressures; and (6) low self-efficacy and confidence in using digital health. In our quantitative second phase, 31% (151/487) of the survey participants were found to have never used a form of digital health, while 10.7% (52/487) were low- to medium-frequency users and 48.5% (236/487) were high-frequency users. High-frequency users were more likely to be interested in digital health and had higher self-efficacy. Low-frequency users were more likely to report difficulty affording the financial costs needed for digital access. Conclusions While general digital interest, financial cost, and digital health literacy and empowerment are clear factors in digital health access in a broad primary care population, the digital health divide is also facilitated in part by a stepped series of complex and cumulative barriers. Genuinely improving digital health access for 1 cohort or even 1 person requires a series of multiple different interventions tailored to specific sequential barriers. Within primary care, patient-centered care that continues to recognize the complex individual needs of, and barriers facing, each patient should be part of addressing the digital health divide.

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Section: Our Current Understanding Of the Digital Health Dividementioning

confidence: 99%

Evaluating the Digital Health Experience for Patients in Primary Care: Mixed Methods Study

Choy,

O'Brien,

Barnes

et al. 2024

J Med Internet Res

Self Cite

View full text Add to dashboard Cite

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Internet-based, continuously available Narcotics Anonymous meetings: a new resource for access to Twelve Step support for abstinence

Galanter,

White,

Hunter

et al. 2024

The American Journal of Drug and Alcohol Abuse

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Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

Delaforce,

Maddock,

Wheeler

et al. 2024

JBI Evidence Implementation

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Introduction: Uptake of virtual care solutions in primary care settings has increased exponentially, and current evidence suggests high patient satisfaction but mixed clinician views. Aims: This paper aimed to identify factors influencing its’ implementation to support delivery to the right patient, in the right clinical context, at the right time. Further, this paper evaluates how the updated Consolidated Framework for Implementation Research (CFIR) can be used to assess these factors that contribute to the uptake of virtual care innovations. Methods: This systematic scoping review identified empirical research on factors influencing the uptake of virtual care solutions in the Australian primary care setting. Searches were undertaken in Embase, PubMed, Scopus, and Web of Science. The CFIR was used to code factors influencing the implementation of virtual care solutions. Inductive coding was used to generate new constructs where no appropriate CFIR construct could be identified. Results: Fourteen eligible studies were identified as eligible for inclusion. Five common influencing factors were identified. Three are from the existing CFIR framework, and two are newly developed constructs. CFIR constructs included innovation relative advantage, capability, and IT infrastructure. New constructs included accessibility and suitability. A further six new constructs were identified (trust, privacy, governance, unintended consequences, preference, and choice) but these were not prominently mentioned. Conclusions: Common factors influence virtual care uptake in Australian primary care. The CFIR assisted in conceptualizing these but was not sufficient for capturing factors unique to virtual care. Newly developed constructs are noted to be of importance in the literature, but further research is needed to understand whether they are applicable in multiple contexts. Spanish abstract: http://links.lww.com/IJEBH/A286

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Changes in general practice use and costs with COVID-19 and telehealth initiatives: analysis of Australian whole-population linked data

Cited by 4 publications

References 24 publications

Evaluating the Digital Health Experience for Patients in Primary Care: Mixed Methods Study

Evaluating the Digital Health Experience for Patients in Primary Care: Mixed Methods Study

Internet-based, continuously available Narcotics Anonymous meetings: a new resource for access to Twelve Step support for abstinence

Factors that influence the uptake of virtual care solutions in Australian primary care practice: a systematic scoping review

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