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Results From a National Survey

Laurence Baker, PhD; Todd H. Wagner, PhD; Sara Singer, MBA; M. Kate Bundorf, PhD, MBA, MPH

JAMA. 2003;289:2400-2406.

Context  The Internet has attracted considerable attention as a means to improve health and health care delivery, but it is not clear how prevalent Internet use for health care really is or what impact it has on health care utilization. Available estimates of use and impact vary widely. Without accurate estimates of use and effects, it is difficult to focus policy discussions or design appropriate policy activities.

Objectives  To measure the extent of Internet use for health care among a representative sample of the US population, to examine the prevalence of e-mail use for health care, and to examine the effects that Internet and e-mail use has on users' knowledge about health care matters and their use of the health care system.

Design, Setting, and Participants  Survey conducted in December 2001 and January 2002 among a sample drawn from a research panel of more than 60 000 US households developed and maintained by Knowledge Networks. Responses were analyzed from 4764 individuals aged 21 years or older who were self-reported Internet users.

Main Outcome Measures  Self-reported rates in the past year of Internet and e-mail use to obtain information related to health, contact health care professionals, and obtain prescriptions; perceived effects of Internet and e-mail use on health care use.

Results  Approximately 40% of respondents with Internet access reported using the Internet to look for advice or information about health or health care in 2001. Six percent reported using e-mail to contact a physician or other health care professional. About one third of those using the Internet for health reported that using the Internet affected a decision about health or their health care, but very few reported impacts on measurable health care utilization; 94% said that Internet use had no effect on the number of physician visits they had and 93% said it had no effect on the number of telephone contacts. Five percent or less reported use of the Internet to obtain prescriptions or purchase pharmaceutical products.

Conclusions  Although many people use the Internet for health information, use is not as common as is sometimes reported. Effects on actual health care utilization are also less substantial than some have claimed. Discussions of the role of the Internet in health care and the development of policies that might influence this role should not presume that use of the Internet for health information is universal or that the Internet strongly influences health care utilization.

Author Affiliations: Department of Health Research and Policy, Stanford University School of Medicine (Drs Baker, Wagner, and Bundorf), and Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University (Drs Baker, Wagner, and Bundorf and Ms Singer), Stanford, Calif; National Bureau of Economic Research, Cambridge, Mass (Drs Baker and Bundorf); and VA Health Services Research and Development Health Economics Resource Center, VA Palo Alto Health Care System, Palo Alto, Calif (Dr Wagner).

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