Exploring eHealth Literacy and Patient-Reported Experiences With Outpatient Care in the Hungarian General Adult Population: Cross-Sectional Study

Abstract

Background Digital health, which encompasses the use of information and communications technology in support of health, is a key driving force behind the cultural transformation of medicine toward people-centeredness. Thus, eHealth literacy, assisted by innovative digital health solutions, may support better experiences of care. Objective The purpose of this study is to explore the relationship between eHealth literacy and patient-reported experience measures (PREMs) among users of outpatient care in Hungary. Methods In early 2019, we conducted a cross-sectional survey on a large representative online sample recruited from the Hungarian general population. eHealth literacy was measured with the eHealth Literacy Scale (eHEALS). PREMs with outpatient care were measured with a set of questions recommended by the Organisation for Economic Co-operation and Development (OECD) for respondents who attended outpatient visit within 12 months preceding the survey. Bivariate relationships were explored via polychoric correlation, the Kruskal–Wallis test, and chi-square test. To capture nonlinear associations, after controlling covariates, we analyzed the relationship between eHEALS quartiles and PREMs using multivariate probit, ordinary least squares, ordered logit, and logistic regression models. Results From 1000 survey respondents, 666 individuals (364 females, 54.7%) were included in the study with mean age of 48.9 (SD 17.6) years and mean eHEALS score of 29.3 (SD 4.9). Respondents with higher eHEALS scores were more likely to understand the health care professionals’ (HCPs’) explanations (χ29=24.2, P=.002) and to be involved in decision making about care and treatment (χ29=18.2, P=.03). In multivariate regression, respondents with lowest (first quartile) and moderately high (third quartile) eHEALS scores differed significantly, where the latter were more likely to have an overall positive experience (P=.02) and experience fewer problems (P=.02). In addition, those respondents had better experiences in terms of how easy it was to understand the HCPs’ explanations (P<.001) and being able to ask questions during their last consultation (P=.04). Patient-reported experiences of individuals with highest (fourth quartile) and lowest (first quartile) eHEALS levels did not differ significantly in any items of the PREM instrument, and neither did composite PREM scores generated from the PREM items (P>.05 in all models). Conclusions We demonstrated the association between eHealth literacy and PREMs. The potential patient-, physician-, and system-related factors explaining the negative experiences among people with highest levels of eHealth literacy warrant further investigation, which may contribute to the development of efficient eHealth literacy interventions. Further research is needed to establish causal relationship between eHealth literacy and patient-reported experiences.

Epidemiology and patients’ self-reported knowledge of implantable medical devices: Results of a cross-sectional survey in Hungary

“…Firstly, respondents with secondary and tertiary education were slightly overrepresented. Such differences are commonly observed for online sampling methods, fairly similar results have been published before [12]. Therefore, the effect of the difference in educational level on our results is considered negligible.…”

A Comprehensive Analysis of E-Health Literacy Research Focuses and Trends

“…Studies have shown that individuals with greater levels of e-health literacy are linked to regular online searches for health information [ 45 ], as well as greater frequency of web-based health-seeking actions [ 46 ]. Individuals with better e-health literacy can acquire more accurate health-related information, evaluate the quality of information more properly, have better self-management capacity, connect with healthcare practitioners more effectively, and engage in treatment and nursing decision-making [ 47 , 48 ]. Furthermore, in the case of the COVID-19 pandemic, the higher the level of e-health literacy, the greater the willingness to receive vaccination and the better the compliance with public health guidelines [ 49 ].…”

Self-Reported Waiting Times for Outpatient Health Care Services in Hungary: Results of a Cross-Sectional Survey on a National Representative Sample

“…The online sample of 1000 respondents represented well the Hungarian adult population considering sex, age, type of settlement, and region of residence. A comparison of the distribution of the sample with the Hungarian general population based on the last census in 2011 is available in [ 15 ]. Of the 1000 participants, 695 individuals had an outpatient consultation at a family doctor, public specialist, or private specialist within the 12 months preceding data collection.…”

“…This was a cross-sectional descriptive study in Hungary, using data collected in 2019 via a web-based survey ‘Patient experiences in health care.’ The survey had three main modules: ‘eHealth literacy’ [ 15 ], ‘Shared decision-making’ [ 16 ], and ‘Patient-reported experience measures’ [ 17 , 18 ]. From the ‘Patient-reported experience measures’ module, we selected questions on waiting times as the focus, namely, on a set of patient-reported experience measures proposed by the OECD [ 5 ].…”