Informational Empowerment: Cross-National Comparison of Internet Health Information Use and ‘Patient-Consumer’ Behaviour

The internet is portrayed as the harbinger of fundamental change in the nature of consumer healthcare behaviours. It offers the scope to ‘equalize’ the power and knowledge asymmetries that characterize healthcare service delivery, addressing a central contemporary challenge in health to ensure that the patient voice is heard (von Roenn 2013). The internet’s impact on the behaviour of the ‘patient-consumer’ cannot be isolated from the social and political context within which consumers and professionals interact. Yet there is a lack of methodogically robust cross-national evidence regarding consumer use of the internet for healthcare purposes and how this shapes utilisation of healthcare services. This research addresses this gap by examining the ‘patient-consumer’ use of the internet for healthcare purposes and associated health-related behaviour across China, Colombia, France, the UK and the USA. The overall research project involved four strands of activity conducted across all five countries. (1) analysis of key features of respective healthcare systems and prevailing policy agenda; (2) interviews with healthcare managers, policy makers and academics to enhance understanding of respective healthcare systems and policy agendas; (3) survey of 623 (UK) and 200 participants each in France, China, Colombia and the USA to gather comparative data on patterns of information usage; (4) two focus groups in each country with 8–10 patients to understand the rationale for information acquisition and utilisation behaviours. In this paper a descriptive analysis of the survey strand is offered, with insights from the qualitative elements, to establish the comparative patterns in use of the internet for healthcare purposes. It is evident from the data gathered across the five national contexts in which the research was conducted that consumers are active in using the internet for a wide variety of healthcare purposes. The key differences and commonalities can be summarised according to the following themes (1) access and attitudes to the internet for healthcare issues (2) patterns of use, e.g., divergence in accessing tangible support (3) attitudes to healthcare professionals, in terms of accepting, or not, professional authority. However, it is equally apparent that prevailing assumptions of wholesale change in patient-consumer behaviour and direct challenging of health professionals are unduly simplistic, in terms of both variability across consumers within specific locations and variability across locations. The particular configuration of the prevailing healthcare system is fundamental in shaping the particular patterns of change. However, the structure of the consultation requires to be rethought to reflect the diversity of patient-consumer behaviours and expectations. Irrespective of the nature of the internet space, the effect is to create a driver for change, with the potential to challenge established practices of both consumers and professionals to reshape the healthcare service encounter. Further analysis of the intra-group patterns will be made available.