Patient satisfaction, e-health and the evolution of the patient-general practitioner relationship: Evidence from an Italian survey.
BACKGROUND
Scientific and public interest in the use of the Internet for health-related purposes has grown considerably. Concerns regarding its impact on patient-doctor relationship and risks for patients have inflamed the debate. Literature provides scarce evidence in this field. This paper investigates whether a patient's decision to use the web also depends on previous experience and satisfaction with healthcare.


METHODS
Statistical analyses were conducted using data from a survey of more than 1700 citizens in Tuscany (Italy). The Andersen behavioural model was adopted as framework for investigating two patient behaviours: Internet use for health-related purposes; discussion of online findings with the physician. Two separate multivariate logistic models were performed to verify whether satisfaction and experience with healthcare system and general practitioners were associated with the e-health behaviours.


RESULTS
Age, education and dissatisfaction with the healthcare system are the main determinant factors of e-health use. The behaviour of sharing the e-health experience with general practitioners is more diffused among those patients who are more satisfied with physicians for the involvement in the decision-making process and suggestions on life-style.


CONCLUSIONS
Whether patients choice to share information found online with the doctor depends on the ability of the doctor to engage patients in decision-making, e-health can produce a 'double-empowerment' process: experienced by the patient on the Internet, and legitimated by the doctor during encounters.
Scuola Superiore Sant'Anna, Istituto di Management, Laboratorio Management e Sanità, Pisa, Italy. Electronic address: s.derosis@sssup.it.
Sabina
S
De Rosis
Scuola Superiore Sant'Anna, Istituto di Management, Laboratorio Management e Sanità, Pisa, Italy.
Sara
S
Barsanti
D003142:Communication; D003430:Cross-Sectional Studies; D003657:Decision Making; D003695:Delivery of Health Care / Q000379:methods; D058005:General Practitioners; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D007558:Italy; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires
Behaviour; Doctor–patient relationship; E-health; E-patient; Empowerment; General practitioners; Health literacy; Healthcare system; Satisfaction