Abstract
Internet access has lagged behind for patients with lower incomes and from certain ethnic groups. This study investigated the possible improvement of access to health-related information on the Internet for all patients in an urban outpatient setting, regardless of socioeconomic background. A 28-question survey was completed by 100 orthopedic outpatients evaluating associations between their age, ethnicity, income, or education level and their access to the Internet. The survey also examined how patients used the Internet to obtain information about their medical condition, their privacy concerns when conducting online research, and their use of mobile phones as a primary means of Internet access.
The Internet was used by 57% of orthopedic outpatients in this urban setting. Internet access decreased with advancing age but increased with increasing income and education, findings consistent with similar studies. Despite the inability to identify an association between ethnicity and Internet access in this patient population, fewer Latinos (33%) than whites (67%) or African Americans (77%) sought information about their medical condition. Among patients who used a mobile phone as the primary method for online access, 74% were African American or Latino and 26% were white. This difference in mobile phone use for online access suggests that mobile phones have provided ethnic minorities with greater Internet access and thus may have narrowed the digital divide among the races.
- 1.Gupte C, Hassan A, McDermott I, Thomas R. The internet: friend or foe? A questionnaire study of orthopaedic out-patients. Ann R Coll Surg Engl. 2002; 84:187–192. Medline, Google Scholar
- 2.Berland GK, Elliott MN, Morales LS, Health information on the internet. JAMA. 2001; 285(20):2612–2621.
10.1001/jama.285.20.2612 Crossref Medline, Google Scholar - 3.Fox S. Health topics. Pew Research Center’s Internet & American Life Project. http://pewinternet.org/~/media//Files/Reports/2011/PIP_Health_Topics.pdf. Accessed January 7, 2013. Google Scholar
- 4.Brooks BA. Using the internet for patient education. Orthop Nurs. 2001; 20(5):69–77.
10.1097/00006416-200109000-00011 Crossref Medline, Google Scholar - 5.Murray E, Lo B, Pollack L, The impact of health information on the internet on health care and the physician-patient relationship: National US survey among 1.050 US physicians. J Med Internet Res. 2003; 5(3):e17.
10.2196/jmir.5.3.e17 Crossref Medline, Google Scholar - 6.Krempec J, Hall J, Biermann JS. Internet use by patients in orthopaedic surgery. Iowa Orthop J. 2003; 23:80–82. Medline, Google Scholar
- 7.Nazarian DG. Influence of the internet in an orthopaedic practice: survey of 500 patients. University of Pennsylvania Orthopaedic Journal. 2002; 15:61–65. Google Scholar
- 8.Beall MS, Beall MS, Greenfield MLV, Biermann JS. Patient internet use in a community outpatient orthopaedic practice. Iowa Orthop J. 2002; 22:103–107. Medline, Google Scholar
- 9.Beall MS, Golladay GJ, Greenfield MLV, Hensinger RN, Biermann JS. Use of the internet by pediatric orthopaedic outpatients. J Pediatr Orthop. 2002; 22(2):261–264.
10.1097/01241398-200203000-00026 Crossref Medline, Google Scholar - 10.Fox S. Online health. Pew Research Center’s Internet & American Life Project. http://www.pewinternet.org/~/media//Files/Reports/2006/PIP_Online_Health_2006.pdf. Accessed January 7, 2013. Google Scholar
- 11.Badarudeen S, Sabharwal S. Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites. J Bone Joint Surg Am. 2008; 90(1):199–204.
10.2106/JBJS.G.00347 Crossref Medline, Google Scholar - 12.Parekh SG, Sodha S, McGuire KJ, Bozentka DJ, Rozental TD, Beredjiklian PK. The digital divide phenomenon in a hand surgery outpatient clinic. Clin Orthop Relat Res. 2004; 421:54–59.
10.1097/01.blo.0000126943.34267.c6 Crossref, Google Scholar - 13.Brodie M, Flournoy RE, Altman DE, Blendon RJ, Benson JM, Rosenbaum MD. Health information, the Internet, and the digital divide. Health Aff. 2000; 19(6):255–265.
10.1377/hlthaff.19.6.255 Crossref, Google Scholar - 14.Baker JF, Devitt BM, Kiely PD, Prevalence of internet use amongst an elective spinal surgery outpatient population. Eur Spine J. 2010; 19(10):1776–1779.
10.1007/s00586-010-1377-y Crossref Medline, Google Scholar - 15.Rainie H, Packel D. More online, doing more: 16 million newcomers gain internet access in the last half of 2000 as women, minorities, and families with modest incomes continue to surge online. Pew Research Center’s Internet & American Life Project. http://www.pewinternet.org/~/media//Files/Reports/2001/PIP_Changing_Population.pdf. Accessed January 7, 2013. Google Scholar
- 16.Zickuhr K, Smith A. Digital differences: Pew Research Center’s Internet & American Life Project. http://pewinternet.org/~/media/Files/Reports/2012/PIP_Digital_differences_041312.pdf. Accessed January 7, 2013. Google Scholar
- 17.Hoffman DL, Novak TP. Bridging the racial divide on the internet. SCIENCE. 1998; 280:390–391.
10.1126/science.280.5362.390 Crossref, Google Scholar - 18.DeNavas-Walt C, Proctor B, Smith J. Income, poverty, and health insurance coverage in the United States: 2011. US Census Bureau. http://www.census.gov/prod/2012pubs/p60-243.pdf. Accessed January 7, 2013. Google Scholar
- 19.Ryan CL, Siebens J. Educational attainment in the United States: 2009. US Census Bureau. http://www.census.gov/prod/2012pubs/p20-566.pdf. Accessed January 7, 2013. Google Scholar
- 20.Jansen BJ. Use of the internet in higher-income households: Pew Research Center’s Internet & American Life Project. http://pewinternet.org/~/media//Files/Reports/2010/PIP-Better-off-households-final.pdf. Accessed January 7, 2013. Google Scholar
- 21.Humes K, Jones NA, Ramirez RR. Overview of race and Hispanic origin: 2010.US Census Bureau. http://www.census.gov/prod/cen2010/briefs/c2010br-02.pdf. Accessed January 7, 2013. Google Scholar

