Abstract
BackgroundThe COVID-19 pandemic has given an unprecedented boost to already increased digital health services, which can place many vulnerable groups at risk of digital exclusion. To improve the likelihood of achieving digital health equity, it is necessary to identify and address the elements that may prevent vulnerable groups from benefiting from digital health services. This study examined the challenges experienced by vulnerable groups in using digital health services during the COVID-19 pandemic.MethodsQualitative descriptive design was utilized. Semi-structured interviews were conducted between October 2020 and May 2021. The participants (N = 74) were older adults, migrants, mental health service users, high users of health services, and the unemployed. Qualitative content analysis with both inductive and deductive approach was used to analyze the data. Challenges related to the use of digital health services were interpreted through digital determinants of health from the Digital Health Equity Framework.ResultsFor most of the participants the access to digital health services was hampered by insufficient digital, and / or local language skills. The lack of support and training, poor health, as well as the lack of strong e-identification or suitable devices also prevented the access. Digital services were not perceived to be applicable for all situations or capable of replacing face-to-face services due to the poor communication in the digital environment. Fears and the lack of trust regarding digital platforms were expressed as well as concerns related to the security of the services. Contact with a health care professional was also considered less personal and more prone to misunderstandings in the digital environment than in face-to-face services. Finally, digital alternatives were not always available as desired by participants, or participants were unaware of existing digital services and their value.ConclusionSeveral development needs in the implementation of digital health services were identified that could improve equal access to and benefits gained from digital services in the future. While digital health services are increasing, traditional face-to-face services will still need to be offered alongside the digital ones to ensure equal access to services.
Highlights
The COVID-19 pandemic has placed health care systems globally in an unprecedented position
The elements related to digital determinants of health that challenged the opportunities of vulnerable groups to benefit from digital health services were partly congruent, and unique
Access to digital resources For the most participants, access to digital health services was hampered by insufficient digital skills, language skills, or both
Summary
The COVID-19 pandemic has placed health care systems globally in an unprecedented position. The variety and the number of digital health services has increased significantly over the past decade already before the pandemic, but it has been argued that the COVID-19 crisis will revolutionize the delivery of health services through digital technology [3, 4]. The purpose of digital health services is to enable the availability and continuity of services during the pandemic, everyone does not have an equal opportunity to benefit from digitalization. The COVID-19 pandemic has given an unprecedented boost to already increased digital health services, which can place many vulnerable groups at risk of digital exclusion. This study examined the challenges experienced by vulnerable groups in using digital health services during the COVID-19 pandemic
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