title: Is the digital divide an obstacle to e-health? An analysis of the situation in Europe and in Italy.
abstract: BACKGROUND
  The digital divide affecting elderly patients may compromise the diffusion of telemedicine systems for this age segment. It might be that the difficulties in the passage from trials to the effective distribution of telemedicine systems are also due to the awareness of a personal digital divide in the target population.
  
  
  METHODS
  The analysis aims to estimate the number of people over the age of 50 years with potential cardiovascular problems able to access the Web. It made use of data from several sources (the Survey of Health, Ageing and Retirement in Europe and the Istituto Nazionale di Statistica Multiscopo Survey). Furthermore, with regard to Italy, the estimates obtained from official data were compared with those obtained in a survey investigating heart failure patients in Tuscany.
  
  
  RESULTS
  In 2011, the percentage of people suffering from cardiovascular diseases and with Web access was 24% in Europe, with significant differences by country (ranging from 53% in Switzerland to below 20% in Italy, Spain, and Portugal). In Italy, however, the proportion of people with Web access increased from 2007 to 2011, and the survey in Tuscany showed that elderly people with limited information and communications technology skills overcame challenges and learned how to connect to the Web because they started to appreciate new technologies.
  
  
  CONCLUSIONS
  The opportunity to use the Internet to monitor patients with chronic disease can serve as a challenge to reduce the digital divide gap and, furthermore, to increase their social and technological inclusion.
authors.affiliation: 1 Institute of Economics, Sant'Anna School of Advanced Studies, Pisa, Italy .
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Romano
authors.forename: Maria Vittoria
authors.initials: MV
authors.lastname: Sardella
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Alboni
authors.forename: Luana
authors.initials: L
authors.lastname: Russo
authors.forename: Rita
authors.initials: R
authors.lastname: Mariotti
authors.forename: Irene
authors.initials: I
authors.lastname: Nicastro
authors.forename: Valentina
authors.initials: V
authors.lastname: Barletta
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D066310:Digital Divide; D005060:Europe; D005260:Female; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D017216:Telemedicine / Q000295:instrumentation*
keywords: cardiology/cardiovascular disease; e-health; home health monitoring; telemedicine