title: Medical text-based consultations on the Internet: a 4-year study.
abstract: BACKGROUND
  The Internet is increasingly used for health matters including Ask the doctor services.
  
  
  OBJECTIVE
  To describe users and usage pattern of text-based medical consultation with family physicians on the Internet.
  
  
  METHODS
  Descriptive analysis of the first 4 years' use of a Swedish Ask the doctor service concerning number of inquiries, age and gender of inquirers. Time of day and week, types of medical inquiries, and use in relation to population density was analyzed during the last year of the study.
  
  
  RESULTS
  We found a considerable number of users, with 38,217 inquiries submitted to the service. Three-fourths of the inquirers were women, thus exceeding the gender difference seen in regular health care. The typical user was a woman aged 21-60 years. The service was used any time day or night, 7 days a week. Almost half of the inquiries were submitted during evenings and nights. Most areas of medicine were represented in the inquiries, reflecting the fact that there was no control of what an inquiry should include. The use was widespread over the country but more frequent per capita in more densely populated areas as defined by postal code.
  
  
  CONCLUSIONS
  In the study of a service for text-based consultations with family physicians on the Internet, we found a geographically widely distributed use, slowly but gradually increasing during a 4-year period. The use increased more rapidly among young and middle-aged women. Asynchronous text-based consultation is likely to expand in the near future.
authors.affiliation: Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Sweden. umefjord@ymex.net
authors.forename: Göran
authors.initials: G
authors.lastname: Umefjord
authors.forename: Herbert
authors.initials: H
authors.lastname: Sandström
authors.forename: Hans
authors.initials: H
authors.lastname: Malker
authors.forename: Göran
authors.initials: G
authors.lastname: Petersson
mesh_terms: D022126:Access to Information; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D008490:Medical Informatics; D008875:Middle Aged; D010817:Physician-Patient Relations; D019114:Remote Consultation / Q000706:statistics & numerical data*; D013548:Sweden