title: The Association Between Internet Use and Ambulatory Care-Seeking Behaviors in Taiwan: A Cross-Sectional Study.
abstract: Compared with the traditional ways of gaining health-related information from newspapers, magazines, radio, and television, the Internet is inexpensive, accessible, and conveys diverse opinions. Several studies on how increasing Internet use affected outpatient clinic visits were inconclusive.
  
  
  
  The objective of this study was to examine the role of Internet use on ambulatory care-seeking behaviors as indicated by the number of outpatient clinic visits after adjusting for confounding variables.
  
  
  
  We conducted this study using a sample randomly selected from the general population in Taiwan. To handle the missing data, we built a multivariate logistic regression model for propensity score matching using age and sex as the independent variables. The questionnaires with no missing data were then included in a multivariate linear regression model for examining the association between Internet use and outpatient clinic visits.
  
  
  
  We included a sample of 293 participants who answered the questionnaire with no missing data in the multivariate linear regression model. We found that Internet use was significantly associated with more outpatient clinic visits (P=.04). The participants with chronic diseases tended to make more outpatient clinic visits (P<.01).
  
  
  
  The inconsistent quality of health-related information obtained from the Internet may be associated with patients' increasing need for interpreting and discussing the information with health care professionals, thus resulting in an increasing number of outpatient clinic visits. In addition, the media literacy of Web-based health-related information seekers may also affect their ambulatory care-seeking behaviors, such as outpatient clinic visits.
authors.affiliation: Department of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Ronan Wenhan
authors.identifier: 0000-0003-1899-9812
authors.initials: RW
authors.lastname: Hsieh
authors.affiliation: Institute of Population Health Sciences, National Health Research Institutes, Miao-Li, Taiwan.
authors.forename: Likwang
authors.identifier: 0000-0002-7923-9182
authors.initials: L
authors.lastname: Chen
authors.affiliation: National Taiwan University College of Law, Taipei, Taiwan.
authors.forename: Tsung-Fu
authors.identifier: 0000-0001-7256-9616
authors.initials: TF
authors.lastname: Chen
authors.affiliation: Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taipei, Taiwan.
authors.forename: Jyh-Chong
authors.identifier: 0000-0002-2423-5950
authors.initials: JC
authors.lastname: Liang
authors.affiliation: Department of Education, National Taiwan Normal University, Taipei, Taiwan.
authors.forename: Tzu-Bin
authors.identifier: 0000-0002-1379-0860
authors.initials: TB
authors.lastname: Lin
authors.affiliation: Graduate Institute of Medical Education & Bioethics, National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yen-Yuan
authors.identifier: 0000-0003-4924-9053
authors.initials: YY
authors.lastname: Chen
authors.affiliation: Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taipei, Taiwan.
authors.forename: Chin-Chung
authors.identifier: 0000-0001-7744-9971
authors.initials: CC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D013624:Taiwan
keywords: Internet; ambulatory care; literacy; mass media; outpatient clinic