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Digital Health Care Demand or eHealth Care Demand in Europe – Eurostat

September 28, 2010

Lately, I have been working with aggregate data from Eurostat ICT usage household survey focused on the usage of the Internet and Health by European citizens. It is worth mentioning that this is a working in progress. Below you can find all variables available per year.

Table 1. Variables available per year at Eurostat ICT usage household survey

Caption	Years
The type of goods and services I ordered over the Internet in the last 12 months for on-work use are: Medicine							2009
The type of goods and services I ordered over the Internet in the last 12 months for non-work use are: Non-prescribed medicine							2009
The type of goods and services I ordered over the Internet in the last 12 months for non-work use are: Prescribed medicine							2009
I would like to do on-line: health-related services (eg interactive advice on availability of services in different hospitals, appointments for hospitals) I_GOVHLP			***	2006
I’ve already done on-line: health-related services (eg interactive advice on availability of services in different hospitals, appointments for hospitals) I_GOVHLY			***	2006
I have used Internet, in the last 3 months, for seeking medical advice online with a practitioner I_IHAD	2003	2004	2005
I used Internet, daily, for seeking medical advice online with a practitioner	2003	2004
I used Internet, monthly, for seeking medical advice online with a practitioner	2003	2004
I rarely used Internet for seeking medical advice online with a practitioner	2003	2004
I used Internet, weekly, for seeking medical advice online with a practitioner	2003	2004
I have used Internet, in the last 3 months, for making an appointment online with a practitioner I_IHAP	2003	2004	2005
I used Internet, daily, for making an appointment online with a practitioner	2003	2004
I used Internet, monthly, for making an appointment online with a practitioner	2003	2004
I rarely used Internet for making an appointment online with a practitioner	2003	2004
I used Internet, weekly, for making an appointment online with a practitioner	2003	2004
I have used Internet, in the last 3 months, for seeking health information on injury, disease, nutrition, improving health, etc.) I_IHIF	2003	2004	2005	2006	2007	2008	2009
I used Internet, daily, for seeking health information on injury, disease or nutrition	2003	2004
I used Internet, monthly, for seeking health information on injury, disease or nutrition	2003	2004
I rarely used Internet for seeking health information on injury, disease or nutrition	2003	2004
I used Internet, weekly, for seeking health information on injury, disease or nutrition	2003	2004
I have used Internet, in the last 3 months, for requesting a prescription online from a practitioner I_IHPR	2003	2004	2005
I used Internet, daily, for requesting a prescription online from a practitioner	2003	2004
I used Internet, monthly, for requesting a prescription online from a practitioner	2003	2004
I rarely used Internet for requesting a prescription online from a practitioner	2003	2004
I used Internet, weekly, for requesting a prescription online from a practitioner	2003	2004

Due to the data available, I have chosen 2005 to carry out a cluster analysis to develop a typology of Digital Health Care Demand or eHealth Care Demand in Europe. This is just a first step, the aim is to analyse the drivers and barriers of eHealth in Europe from the demand side. The next table shows the percentage of total individuals by country, (I_GOVHLP and I_GOVHLY 2006)

Table 2. eHealth variables available 2005 at Eurostat ICT usage household survey

COUNTRY	I_IHIF	I_GOVHLP	I_GOVHLY	I_IHAD	I_IHAP	I_IHPR
AT	0,160251	0,227954	0,029526	0,004705	0,007748	0,002626
BE	0,1914	0,183276	0,017496
BG		0,122097	0,009661
CA	0,58
CY	0,080042	0,195897	0,00136	0,002788	0,000551	0,001706
CZ	0,034713	0,096489	0	0,003308	0,003896
DE		0,325024	0,021079
DK	0,238382	0,41458	0,030644	0,02493	0,016902	0,007123
EA	0,162218	0,251884	0,017979		0,005567	0,003255
EA16
EE	0,163774	0,19904	0,030725	0,108567	0,083567	0,049192
EL	0,021608	0,131537	0,001472	0,003506	0,001282	0,000433
ES	0,12751		0,035553	0,024121	0,004409	0,000907
EU15	0,181379	0,245943	0,021312	0,019812	0,005783	0,004567
EU25	0,160867	0,227894	0,019862	0,017239	0,005385	0,004105
EU27	0,160867	0,216619	0,018973	0,017239	0,005385	0,004105
FI	0,38971	0,273988	0,012912	0,027487	0,033743
FR
HR
HU	0,096088	0,119384	0,053411	0,007618	0,004358	0,001954
IE	0,104775	0,043551	0,008591	0,006391	0,001092	0,000679
IS	0,394597	0,388167	0,119582	0,027373	0,013017	0,007694
IT	0,087271	0,17439	0,008182	0,015709	0,003513	0,001996
LT	0,085267	0,179464	0,020233	0,012467	0,002665	0
LU	0,410491	0,367017	0,015976	0,016174	0,006943	0,007728
LV	0,073536	0,156269	0,009821	0,004649	0,001445	0,00052
MK
MT	0,161734	0,122316	0,010373	0,004483	0,003271	0,001495
NL	0,407242	0,387001	0,008289	0,017196	0,007235	0,014481
NO	0,257325	0,36145	0,021409	0,0113	0,008636	0,002586
PL	0,071422	0,174514	0,00652	0,004253	0,001301	0,000916
PT	0,100267	0,174263		0,003997
RO		0,062036
RS
SE	0,232107	0,295204	0,061132	0,042376	0	0,009893
SI	0,153678	0,268123	0,011941			0
SK	0,091329	0,214051	0,013288	0,000493	0,001545	0,000192
TR	0,031177			0,002588	0,000698	0,000024
UK	0,254573	0,200448	0,02922	0,044428

With these values I have constructed new categorical variables considering descriptive statistics (percentiles per each variable) as follow: less than 25% is LOW, between 25% and 75% is MEDIUM and more than 75% is HIGH.

In order to develop a typology of countries’ utilization of the Internet related with Health, a Non-Hierarchical Cluster Analysis of K-means was undertaken, to five of the five variables identified above I_IHIF, I_GOVHLP, I_GOVHLY, I_IHAD, I_IHAP (Table 2). These factors were selected due to their significance within the cluster analysis.

Table 3. Results of K-means—quick cluster analysis. Method of analysis: non-hierarchical cluster, final cluster centroids.

		Clusters
	1. Digital Health Care Demand Leaders (n=8)	2. Digital Health Care Demand Primary Strivers (n=3)	3. Digital Health Care Demand Secondary Strivers (n=12)	ANOVA	Sig.
I_IHIF	2,5	3	1,67	12,733	0
I_GOVHLY	3	1,67	1,58	18,345	0
I_GOVHLP	2,5	3	1,58	14,053	0
I_IHAD	2,5	2,33	1,67	6,793	0,006
I_IHAP	2,5	2,67	1,92	4,173	0,031

Cluster one consists of countries where citizens place a greater emphasis on the Internet for health purposes, specially those variables related with health care services. This group is thus referred to as representing ‘Digital Health Care Demand Leaders’. Cluster two is characterised by a minimum difference, with less emphasis on variables related with health care services (transactions) and more emphasis on information, so are consequently labelled ‘Digital Health Care Demand Primary Strivers’. Finally, Cluster 3 is labelled ‘Digital Health Care Demand Secondary Strivers’

And now… the floor is yours…. pick up a country a put it on a cluster… soon I will post the characterization of the cluster analysis, including traditional, non-digital, variables from the health systems. Furthermore… what about 2010?

Austria	AT
Belgium	BE
Bulgaria	BG
Cyprus	CY
Czech Republic	CZ
Germany	DE
Denmark	DK
Estonia	EE
Greece	EL
Spain	ES
Finland	FI
France	FR
Croatia	HR
Hungary	HU
Ireland	IE
Iceland	IS
Italy	IT
Lithuania	LT
Luxembourg	LU
Latvia	LV
Macedonia	MK
Malta	MT
Netherlands	NL
Norway	NO
Poland	PL
Portugal	PT
Romania	RO
Sweden	SE
Slovenia	SI
Slovakia	SK
Turkey	TR
United Kingdom	UK
EU (15 countries)	EU15
EU (25 countries)	EU25
EU (27 countries)	EU27

THANKS indeed Ismael Peña for his inspiring work…

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