title: Association Between Acute Medical Exacerbations and Consuming or Producing Web-Based Health Information: Analysis From Pew Survey Data.
abstract: BACKGROUND
  The Internet is an increasingly important resource for individuals who seek information from both health professionals and peers. While the demographic and health characteristics of persons who use health information technology has been well described, less is known about the relationship between these health characteristics and level of engagement with health information technology. Even less is known about whether persons who produce Web-based health information differ in health status from persons who consume such content.
  
  
  OBJECTIVE
  We explored the health characteristics of persons who engage with the Internet for the purposes of consuming or producing Web-based health information, and specifically, whether healthier versus sicker persons engage with health information technology in different ways.
  
  
  METHODS
  We analyzed data from the 2012 Pew Health survey, a landline and cell phone survey of 3104 adults in the United States. Using multiple logistic regression with sampling weights, we examined the association between sociodemographic and health characteristics and the consumption or production of Web-based health information. Sociodemographic variables included age, sex, race, and education. Health characteristics included self-reported health status, presence of chronic condition(s), and having an acute medical exacerbation. Acute medical exacerbations were defined as an emergency department visit, hospitalization, or other serious medical emergency in the last 12 months.
  
  
  RESULTS
  The majority of the sample reported good or excellent health (79.7%), although 50.3% reported having at least one chronic condition. About a fifth (20.2%) of the sample experienced an acute medical exacerbation in the past year. Education was the sociodemographic characteristic most strongly associated with consuming Web-based health information. The strongest health-related predictors of consuming Web-based health information were an acute medical exacerbation (OR 2.39, P<.001) and having a chronic condition (OR 1.54, P=.007). Having an acute medical exacerbation was the only predictor of producing Web-based health information (OR 1.97, P=.003). All participants, regardless of health status, were most interested in Web-based health information regarding diseases or medical problems. However, persons with acute medical exacerbations were more likely to seek Web-based health information regarding medical tests, procedures, and drugs compared to persons without acute medical exacerbations.
  
  
  CONCLUSIONS
  Producers of Web-based health information differ from consumers of this information in important health characteristics that could skew the content of peer-generated Web-based health information and overrepresent the experiences of persons with acute medical exacerbations. Providers may have a role to play in directing patients towards high-quality, easy-to-understand online information, especially information regarding treatments and procedures.
authors.affiliation: VA Health Economics Resource Center, Menlo Park, CA, United States. risha.gidwani@va.gov.
authors.forename: Risha
authors.identifier: http://orcid.org/0000-0002-3548-2332
authors.initials: R
authors.lastname: Gidwani
authors.forename: Donna
authors.identifier: http://orcid.org/0000-0001-8904-2810
authors.initials: D
authors.lastname: Zulman
mesh_terms: D000328:Adult; D000368:Aged; D040421:Cell Phone; D002908:Chronic Disease / Q000453:epidemiology*; D054626:Consumer Health Information / Q000706:statistics & numerical data*; D018450:Disease Progression; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008490:Medical Informatics / Q000706:statistics & numerical data; D008875:Middle Aged; D011642:Publications; D011795:Surveys and Questionnaires; D014481:United States
keywords: Internet; emergencies; health knowledge, attitudes, practice; hospitalization