What is the relationship between internet use and use of different types of health and social care in older adults recruited via primary care?

Talk Code: 
P1.06
Presenter: 
Caroline Clarke
Co-authors: 
1 Caroline Clarke, 2 Jeff Round, 1 Steve Morris, 2 Kalpa Kharicha, 3 John Ford, 4 Jill Manthorpe, 1 Steve Iliffe, 5 Claire Goodman, 1 Kate Walters
Author institutions: 
1 University College London, 2 University of Bristol, 3 University of East Anglia, 4 King’s College London, 5 University of Hertfordshire

Problem

Much research seeks to find ways of improving health and well-being of older people. One area that has potential is older people’s technology use, with increasing interest in using technology to maintain health and/or to assist in managing or reducing health-related resource use. The WISH study (Well-being Interventions for Social and Health needs) assessed the feasibility of implementing a risk appraisal system for older adults into primary care. It included questions about differential uptake of technology among participating older people. Our aim was to examine the relationship between internet use and health and social care use.

Approach

The WISH study (n=454) collected a broad range of data from participants from five General Practices in two diverse areas, including physical and mental well-being, functional ability, lifestyle and diet, personal characteristics, loneliness and social network factors, use of health care and social resources, and internet and mobile phone use. We performed regression analyses in panel data format (baseline, with follow-up at 3 and 6 months) to investigate the relationship between internet use and resource use, controlling for age, sex and other important factors.

Findings

Use of hospital services and primary care were not associated with internet use in older people. They were predicted largely by physical health considerations (worse health leads to higher resource use), although ethnicity was also significant in hospital use.Use of other health care services (e.g. optician, dentist, physiotherapist) however was significantly associated with internet use (OR 1.763, 95% CI 1.112 to 2.796), after adjusting for age, sex, season (summer or autumn), GP surgery, mental health status, physical health status, recent sudden illness, ethnicity, loneliness, and socio-economic status.Finally, receipt of (mostly unpaid) assistance for washing, cooking and similar tasks was not associated with internet use, and was explained mainly by age, physical and mental health status and socio-economic status. Limitations of the analysis are that no causality can be inferred due to the nature of the study, and we do not have comprehensive information on the reasons for participants’ internet use.

Consequences

Internet use in this group had no association with use of hospital or primary care services, however there was a strong association with use of other healthcare services (e.g. optician, dentist, physiotherapy). This may suggest that older adults’ increasing use of the internet might not help them to stay out of hospital, but might make it easier for them to access other services. Alternatively internet use may be a marker for the ability and/or interest to access a broader range of health services. Further work on these mechanisms is required.

Submitted by: 
Caroline Clarke
Funding acknowledgement: 
NIHR, building on DH PRP.