Growth and determinants of access in patient e-mail and Internet use

Objectives: To measure the rate of access to and use of the Internet and e- mail. to determine sociodemographic predictors of access, and to measure th e change in Internet and e-mail access over a 1-year interval. Design: Survey study. Comparison of data with those from a similar survey f rom 1998. Setting: Emergency department of a large urban pediatric teaching hospital. Participants: Primary caretakers of pediatric patients or the patients them selves if aged 16 years or older. Main Outcome Measures: Use of and access to the Internet or e-mail. Results: We surveyed 214 individuals: 72.8% use or have access to the Inter net, e-mail, or both, an increase from 52.2% in the 1998 survey (P<.001), a nd 48.5% regularly use the Internet or e-mail, compared with 43.1%; in 1998 (P = .32). Outside the home, access is primarily at work (52.2%), schools (8.9%), public libraries (11.5%), and friends' and relatives' houses (16.7% ). Internet use and access are linearly correlated with income (r = 0.43; P <.001). White patients are more likely to have access (odds ratio, 2.6; 95% confidence interval, 1.3-5.4; P<.001) than black or Asian patients, wherea s those of Hispanic ethnicity; are less likely to have access (odds ratio, 0.20; 95% confidence interval, 0.09-0.43; P<.001). However, after adjustmen t for race and Hispanic ethnicity, only income was a significant predictor of family access to the Internet and e-mail. Conclusions: During the past pear, many patients have gained access to the Internet and c-mail, although rates of regular use have remained steady. Th is access is often from outside the home. Furthermore, access is directly r elated to income and is unevenly distributed across racial and ethnic group s.