Does Internet Use Affect Medical Decisions among Older Adults in China? Evidence from CHARLS

Abstract

Background: The rapid growth of the elderly population poses a huge challenge for people to access medical services. The key to get rid of the dilemma is for patients to go firstly to primary medical institutions. Existing studies have identified numerous factors that can affect patients’ health institution choice. However, we currently know little about the role of Internet use in the patients’ medical decisions. The objective of this study is to explore health-seeking behavior and institution choice under the background of the Internet era from the perspective of older adults, and to analyze whether the Internet could guide patients to the appropriate medical institution so as to accomplish hierarchical treatment. Methods: The dataset comprises 9416 people aged 45 or above from the China Health and Retirement Longitudinal Survey (CHARLS), which, through multistage cluster sampling, was conducted in 2011, 2013, and 2015. Logistic regression, PSM, and FE model are used to estimate the influence of Internet use on the health care decision-making behavior. Results: Internet use has a significant positive impact on the self-treatment of common diseases (β = 0.05, p < 0.05). In terms of medical institution choices, those who use Internet are more inclined to choose top-level hospitals than community health service institutions to treat common diseases (β = 0.06, p < 0.01). Conclusions: The Internet has lowered the obstacles to learning about common ailments, resulting in a substitution impact of self-treatment for hospital care. However, Internet use may aggravate older adults’ perception of the risk of disease, which exacerbates the tendency of going to higher-level medical institutions for medical treatment. The finding of the study is useful for further rational planning and utilization of the Internet in order to guide patients to appropriate medical institution, which helps to improve the efficiency of the overall medical and health services.

The Impact of Internet Use on Patients’ Health-seeking Behavior and Health Expenditure: an Empirical Study Based on CFPS Data

“…Participants who used the internet to access information were more likely to choose general/specialized hospitals compared to participants without the internet to access information (P < 0.001), which indicated that the over ow of health information on the internet exacerbated the likelihood of going to higher-level healthcare institutions for seeking health treatment. Similarly, several previous studies were consistent with our nding [27,28].…”

Association Between Internet Use and Physical Health, Mental Health, and Subjective Health in Middle-aged and Older Adults: Nationally Representative Cross-sectional Survey in China

“…In addition, internet use may have a greater impact on the middle-aged population than on the older adult population. It may be that middle-aged people are more receptive to and understanding of information and are therefore better able to use the internet to improve their health [ 77 ].…”

Effects of and Prospects for the Hierarchical Medical Policy in Beijing, China

“…Patient choices and behaviors are driven by a number of factors [ 37 ], including hospital reputation, treatment quality, insurance plan, Internet equipment, and so on. They influence patients’ choice of hospitals to varying degrees [ 38 , 39 , 40 ], according to the research results, “level of physician diagnosis and treatment”, “severe condition of disease”, and “advanced level of medical equipment and technology”. To ensure that “acute and chronic diseases are treated by different facilities” (a goal of the hierarchical medical policy), the municipal government of Beijing needs to strengthen policy publicity and improve infrastructure and service quality in primary hospitals and basic healthcare centers.…”