BACKGROUND In recent years, the healthcare sector has experienced accelerated progress in terms of the inclusion of ICTs in its procedures and formalities. However, public administrations have been unable to adapt to the peculiarities of the most vulnerable groups, leaving them on the margins of the healthcare system and contributing to the widening of the so-called digital divide. OBJECTIVE This article presents the results of a research work developed between 2018 and 2021, which aims to verify how autonomous health systems address the limitations that different groups of users or collectives, in exclusion or at risk of social exclusion, experience in their interaction with electronic health services, determining how inclusive these web portals are (or are not). METHODS Based on the analysis of the literature, three dimensions have been constructed to identify the level of inclusion of web portals: the perception of quality, the perception of usability and the importance attributed to their content. In order to obtain data on each of these dimensions, a study was designed based on the user test methodology as a central element (identifying and evaluating eleven vulnerable groups) and, in parallel, a survey of the general population and heuristic tests. RESULTS A high percentage of vulnerable people affected by risk factors are not receiving adequate healthcare due to the digitalization of the system and the implementation of scarcely inclusive health web portals, which pose significant barriers in service provision for the 11 selected collectives. Meanwhile, the general population is being introduced to eHealth benefits, although the latter did not have high levels of digitization or a broad portfolio of services. CONCLUSIONS The general population values the services relatively positively, but only a minority of them make intensive use of them, and they are not widespread in Spain as a whole. Meanwhile, the population at risk of exclusion lacks the skills and resources to make real use of eHealth, needing "digital intermediaries" from the social sphere to achieve results. eHealth policies are not taking into account people with higher levels of marginalization, aggravating their exclusion and the digital divide.
OBJETIVO: Examinar el enfoque adoptado por los planes de salud de las comunidades autónomas de España verificando el peso otorgado al concepto de equidad; detectar a qué colectivos o situaciones se hace referencia; así como distinguir la perspectiva de abordaje del mismo, desde el acceso, la igualación o la equiparación. MÉTODOS: Estudio cualitativo, de análisis de contenido mediante Nvivo12, realizado en 2020 sobre planes de salud en vigencia a fecha de 2019 en las diferentes regiones (comunidades autónomas) de España. Se han recopilado 16 planes de salud regionales vigentes para establecer categorías base (equidad, accesibilidad e igualdad) y determinar términos asociados a través de Nvivo12, a partir de los que se realizó un análisis de contenido. RESULTADOS: El concepto de equidad no resulta destacado por los planes de salud autonómicos y su relevancia es superada por los conceptos de accesibilidad e igualdad. El empleo de estos tres conceptos está asociado a diversas categorías que connotan circunstancias, condiciones o colectivos a los que los planes prestan mayor atención. CONCLUSIONES: Los resultados obtenidos coinciden con estudios previos sobre los contenidos y orientación de los planes de salud, revelando una presencia discreta del concepto de equidad en los enfoques adoptados, sin que ello menoscabe el alineamiento de las políticas de salud respecto de las visiones emanadas de organizaciones transnacionales. Se detecta la existencia de un colectivo al que se presta especial atención desde el enfoque de accesibilidad, la población con diversidad funcional.
eHealth has grown significantly over the last decade. The aim of this study was to determine the level of use of information and communication technologies for health care in Spain and identify the main barriers to development. We used a qualitative study based on data obtained from 8 Spanish autonomous communities through semi-structured, in-depth interviews with key informants in eHealth management and planning. Programs present varying degrees of implementation. Services such as electronic prescriptions, digital medical records, and appointment requests via the Internet are advanced and widespread; others, such as digital imaging, are advanced but not fully deployed; and some, such as telecare programs, are experimental. The study also revealed diverse levels of interoperability and barriers to the expansion of these technologies, which can be classified into 4 fields: technological, organizational, human, and economic. eHealth might evolve more slowly in the coming years. Unless the payoff is clearly seen, major budget cuts in the current economic climate will prevent the implementation of new projects. Programs that help reduce health spending are more likely to be implemented, to the detriment of projects involving simple techniques or even clear health care improvements.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.