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Exploring the relationship between frequent internet use and health and social care resource use in a community-based cohort of older adults: an observational study in primary care
  1. Caroline S Clarke1,
  2. Jeff Round2,
  3. Stephen Morris3,
  4. Kalpa Kharicha1,
  5. John Ford4,
  6. Jill Manthorpe5,
  7. Steve Iliffe1,
  8. Claire Goodman6,
  9. Kate Walters1
  1. 1 Research Department of Primary Care & Population Health, University College London (UCL), London, UK
  2. 2 School of Social and Community Medicine, University of Bristol, Bristol, UK
  3. 3 Department of Applied Health Research, University College London (UCL), London, UK
  4. 4 Department of Public Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK
  5. 5 Social Care Workforce Research Unit, King’s College London, London, UK
  6. 6 Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
  1. Correspondence to Dr Caroline S Clarke; caroline.clarke{at}


Objectives Given many countries’ ageing populations, policymakers must consider how to mitigate or reduce health problems associated with old age, within budgetary constraints. Evidence of use of digital technology in delaying the onset of illness and reducing healthcare service use is mixed, with no clear consensus as yet. Our aim was to investigate the relationship between frequent internet use and patterns of health or social care resource use in primary care attendees who took part in a study seeking to improve the health of older adults.

Methods Participants recruited from primary care, aged >65 and living in semirural or urban areas in the south of England, were followed up at 3 and 6 months after completing a comprehensive questionnaire with personalised feedback on their health and well-being. We performed logistic regression analyses to investigate relationships between frequent internet use and patterns of service use, controlling for confounding factors, and clustering by general practitioner practice. Four categories of service use data were gathered: use of primary National Health Service (NHS) care; secondary NHS care; other community health and social care services; and assistance with washing, shopping and meals.

Results Our results show, in this relatively healthy population, a positive relationship (OR 1.72, 95% CI 1.33 to 2.23) between frequent internet use and use of any other community-based health services (physiotherapist, osteopath/chiropractor, dentist, optician/optometrist, counselling service, smoking cessation service, chiropodist/podiatrist, emergency services, other non-specific health services) and no relationship with the other types of care. No causal relationship can be postulated due to the study’s design.

Conclusions No observed relationship between frequent internet use and primary or secondary care use was found, suggesting that older adults without internet access are not disadvantaged regarding healthcare use. Further research should explore how older people use the internet to access healthcare and the impact on health.

  • Older adults
  • health service resource use
  • internet use
  • panel data
  • logistic regression
  • primary care

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Contributors CSC, JR and SM designed the analysis, with important intellectual input from KK, JF, JM, SI, CG and KW. CSC cleaned the data set with assistance from KK. CSC conducted the analysis and prepared the manuscript draft. All authors gave valuable input during the drafting process and approved the final manuscript.

  • Funding The WISH study was funded by the Medical Research Council (MRC) LLHW G1001822/1.

  • Disclaimer The MRC had no role in the design, collection, analysis or interpretation of data; in the writing of this manuscript; or in the decision to submit the manuscript for publication.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical approval for the WISH study was granted by London-East Research Ethics Committee (reference 11/LO/1814) which included permissions to conduct the analysis reported in this paper.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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