eHealth Search Patterns: A Comparison of Private and Public Health Care Markets Using Online Panel Data

摘要

Background: Patient and consumer access to e-health information is of crucial importance because of its role in patient-centered medicine, and to improve knowledge about general aspects of health and medical topics.Objective: The objectives are to analyze and compare e-health search patterns in a private (US) and a public (UK) healthcare market.Methods: A new taxonomy of e-health websites is proposed to organize the largest ehealth websites. An online measurement framework is developed that provides a precise and detailed measurement system. Online panel data is used to accurately track and analyze detailed search behavior across 100 of the largest e-health websites in the US and UK healthcare markets.Results: The categories of health, medical and lifestyle account for approximately90% of online activity while e-pharmacies, social media and professional account for the remaining 10%. Overall search penetration of e-health websites is significantly higher in the private (US) than the public market (UK). Almost twice as many e health users in the private market have adopted online search in the health and lifestyle categories and also spend more time per website than in the public market. The use of medical websites for specific conditions is almost identical in both markets. The allocation of search effort across categories is similar in both markets. For all categories, the vast majority of e-health users only access one website within each category. Those that conduct a search of two or more websites display very narrow search patterns. All users spend relatively little time on e-health, i.e. 3 – 7 minutes per website.Conclusions: The proposed online measurement framework exploits online panel data to provide a powerful and objective method of analyzing and exploring e-health behavior. The private healthcare system does appear to have an influence on e-health search behavior in terms of search penetration and time spent per website in the health and lifestyle categories. Two explanations are offered: (1) the personal incentive of medical costs in the private market incentivizes users to conduct online search; (2) healthcare information is more easily accessible through healthcare professionals in the UK compared to the US. However, the use of medical websites is almost identical, suggesting that patients interested in a specific condition have a motivation to search and evaluate health information, irrespective of the healthcare market. The relatively low level of search in terms of the number of websites accessed and the average time per website raise important questions about the actual level of patient informedness in both markets. Areas for future research are outlined.