The key role of digital health literacy in the use of e-health services

Abstract Background The use of e-health services (eHS) increased significantly in Poland during the COVID-19 pandemic. Following the declaration of the COVID-19 epidemic in 2020, remote physician visits (RPVs), along with other eHS, were introduced nationwide with a secured reimbursement scheme. The main aim of this study was to analyze the role of digital health literacy (DHL) in using eHS within the Polish population. Methods The analysis presented here is based on data from an online survey conducted in a representative sample of 1,108 adult Internet users in December 2023. The effect of DHL was assessed using multivariable logistic regression models, adjusting for sociodemographic characteristics and respondents’ health status. Dependent variables were derived from responses to questions about the use of specific e-health services during the preceding 12 months. The analysis covered the use of remote physician visits (RPVs) conducted either by telephone or videoconferencing (VC) within the public healthcare system, use of the Internet Patient Account (IPA), online access to laboratory test results (LAB), mobile lifestyle applications, and private websites offering access to e-prescriptions (EPR). Results The use of telephone-based RPVs was reported by 65.7% of respondents, while VC-based RPVs were used by 37.3%. The use of other e-health services ranged from 19.2% for EPR to 64.8% for the IPA. DHL was a significant positive predictor of the use of all e-health services. Each one-point increase in DHL was associated with a 5% to 12% increase in the likelihood of using a given service. The presence of chronic disease significantly increased the likelihood of using all services, from a 41% increase for VC-based RPVs to a 129% increase for the use of LAB websites, except for EPR. Conclusions DHL is a consistent determinant of eHS use, even after adjusting for sociodemographic characteristics and respondents’ health status, including the presence of chronic disease. Key messages • Digital health literacy is a critical determinant of the use of e-health services. • The presence of chronic diseases also determines the use of the most of e-health services.