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European citizens' use of E-health services: A study of seven countries

Hege K Andreassen1*, Maria M Bujnowska-Fedak2, Catherine E Chronaki3, Roxana C Dumitru4, Iveta Pudule5, Silvina Santana6, Henning Voss7 and Rolf Wynn18

Author affiliations

1 Norwegian Centre for Telemedicine, University Hospital of Northern Norway, Tromsø, Norway

2 Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland

3 Foundation for Research and Technology, Heraklion, Greece

4 Chair of Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany

5 Health Promotion State Agency, Riga, Latvia

6 Universidade de Aveiro, Aveiro, Portugal

7 Danish Centre for Health Telematics, Odense, Denmark

8 Department of Clinical Psychiatry, University of Tromsø, Tromsø, Norway

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Citation and License

BMC Public Health 2007, 7:53  doi:10.1186/1471-2458-7-53

Published: 10 April 2007



European citizens are increasingly being offered Internet health services. This study investigated patterns of health-related Internet use, its consequences, and citizens' expectations about their doctors' provision of e-health services.


Representative samples were obtained from the general populations in Norway, Denmark, Germany, Greece, Poland, Portugal and Latvia. The total sample consisted of 7934 respondents. Interviews were conducted by telephone.


44 % of the total sample, 71 % of the Internet users, had used the Internet for health purposes. Factors that positively affected the use of Internet for health purposes were youth, higher education, white-collar or no paid job, visits to the GP during the past year, long-term illness or disabilities, and a subjective assessment of one's own health as good. Women were the most active health users among those who were online. One in four of the respondents used the Internet to prepare for or follow up doctors' appointments. Feeling reassured after using the Internet for health purposes was twice as common as experiencing anxieties. When choosing a new doctor, more than a third of the sample rated the provision of e-health services as important.


The users of Internet health services differ from the general population when it comes to health and demographic variables. The most common way to use the Internet in health matters is to read information, second comes using the net to decide whether to see a doctor and to prepare for and follow up on doctors' appointments. Hence, health-related use of the Internet does affect patients' use of other health services, but it would appear to supplement rather than to replace other health services.