General perceptions of digitalisation and its impact on the use of digital health applications

Abstract Background Digitalisation shapes modern life and healthcare. Research has shown that digital health applications (DHA) are associated with better health outcomes, but have also revealed negative effects and increased inequalities. To date, little research has examined the role of general perceptions of digitalisation in DHA adoption and in relation to social determinants. The research question is therefore: Are general perceptions of digitalisation associated with the use of digital health applications? Methods The analysis is based on a cross-sectional online survey (HECoS) (2022, N = 1,850), representative for age, gender and federal state according to Eurostat 2020. Participants were asked about their general perceptions of digitalisation and their use of DHA provided by the German statutory health system. In addition, sociodemographic variables were assessed. Bivariate and logistic regression analyses as well as principal component analysis (PCA) (for the general perceptions of digitalisation) were used. Results Two thirds of the participants were rather positive about the development through digitalisation, which was significantly more likely among the socioeconomically privileged participants. Two subscales of positive versus negative perceptions of digitalisation were identified, showing similar social differences. Negative perceptions were associated with higher non-use of online booking (prescription, OR = 1.11, p < =.001), online video consultation (OR = 1.15, p < =.001) and data transfer via a health insurance app (OR = 1.10, p < =.001), even after controlling for digital competence and sociodemographic variables. Conclusions General perceptions of digitalisation play a role in the use of DHA. Therefore, information needs to be balanced so that the public can see the pros and cons of digitalization in general and DHA in particular. This, combined with efforts to increase digital (health) literacy, would enable citizens to make informed decisions about adoption of DHA. Key messages • The study clearly showed that negative perceptions of digitalisation in general influence the use of digital health applications (DHA). • In this context, it is important to provide transparent information about the pros and cons of DHA and to increase digital (health) literacy to enable informed choices.