Publicatie

Publicatie datum

Effect of an evidence-based website on healthcare usage: an interrupted time-series study.

Spoelman, W.A., Bonten, T.N., Waal, M.W.M. de, Drenthen, T., Smeele, I.J.M., Nielen, M.M., Chavannes, N. Effect of an evidence-based website on healthcare usage: an interrupted time-series study. BMJ Open: 2016, 6(e013166)
Lees online
Objectives
Healthcare costs and usage are rising. Evidence-based online health information may reduce healthcare usage, but the evidence is scarce. The objective of this study was to determine whether the release of a nationwide evidence-based health website was associated with a reduction in healthcare usage.

Design
Interrupted time series analysis of observational primary care data of healthcare use in the Netherlands from 2009 to 2014.

Setting
General community primary care. Population: 912 000 patients who visited their general practitioners 18.1 million times during the study period.

Intervention
In March 2012, an evidence-based health information website was launched by the Dutch College of General Practitioners. It was easily accessible and understandable using plain language. At the end of the study period, the website had 2.9 million unique
page views per month.

Main outcomes measures
Primary outcome was the change in consultation rate (consultations/1000 patients/month) before and after the release of the website. Additionally, a reference group was created by including consultations about topics not being viewed at
the website. Subgroup analyses were performed for type of consultations, sex, age and socioeconomic status.

Results
After launch of the website, the trend in consultation rate decreased with 1.620 consultations/ 1000 patients/month ( p<0.001). This corresponds to a 12% decline in consultations 2 years after launch of the website. The trend in consultation rate of the reference group showed no change. The subgroup analyses showed a specific decline for consultations by phone and were significant for all other subgroups, except for the youngest age group.

Conclusions
Healthcare usage decreased by 12% after providing high-quality evidence-based online health information. These findings show that e-Health can be effective to improve self-management and reduce healthcare usage in times of increasing healthcare costs. (aut. ref.)