The Association Between Frequency of Internet Use and Co-occurring Healthcare Needs among Chinese Residents: A Cross-sectional Study (Preprint)

Abstract

BACKGROUND The need for healthcare is the basis of healthcare service provision, as well as the core of service capacity enhancement and resource allocation. Healthcare needs can be affected by health, social and economic conditions and exhibit different characteristics at different time periods. However, previous studies focused merely on a certain group of people or type of need and ignored the diversity and complexity of the healthcare needs of residents. Moreover, with informatisation being a major feature of current social development, whether Internet utilisation can affect the co-occurrence of healthcare needs remains unclear. OBJECTIVE This study aims to determine the co-occurrence of healthcare needs among residents in China, to explore the relationship between Internet use frequency and co-occurring healthcare needs (CHNs) and analyse the potential pathways of influence. METHODS The data were acquired from the ‘Survey on Chinese Residents’ Health Services Needs in the New Era’, conducted from July to August 2018, which yielded a sample of 12,513 individuals. An association rule learning algorithm was used to analyse the characteristics of the CHNs of the Chinese residents, and a generalised linear model was deployed to investigate the relationship between Internet use frequency and CHNs. Furthermore, a path analysis model was employed to investigate the mediating role of health literacy and health status in the aforementioned relationship. RESULTS A substantial proportion (68.74%) of the surveyed population had two or more CHNs, with the rural residents having a lower percentage (66.83%) compared with the urban residents (70.53%). The residents who used the Internet frequently tended to have numerous CHNs (β = 0.895, SE = 0.019, P < .001, 95% CI [0.857–0.934]). Results indicated a positive relationship between Internet use frequency and improved health literacy (β = 0.121, SE = 0.011, P < .001) and health status (β = 0.026, SE = 0.049, P < .001). Notably, a high level of health literacy was associated with increased CHNs (β = 0.087, SE = 0.054, P < .001). By contrast, a notable negative correlation was observed between health status and CHNs (β = -0.787, SE = -0.213, P < .001), which indicated that CHNs decreased as health status improved. CONCLUSIONS The findings can serve as a reminder for health policymakers and healthcare providers to focus on evolving healthcare needs and the impact of information technology on such needs in the current era. Healthcare providers must adjust their services and service delivery methods to meet the CHNs of residents. Meanwhile, policymakers and service managers should ensure the keeping pace of service delivery with changing needs through resource allocation, health insurance payment reforms and performance incentives. CLINICALTRIAL The questionnaire design and study protocol were approved by the Ethics Committee of Tongji Medical College of Huazhong University of Science and Technology (# IORG0003571).