Determinants of access to eHealth services in regional Australia

Khorshed Alam (Corresponding Author), Rashidul Alam Mahumud, Fariha Alam, Syed Afroz Keramat, Michael O. Erdiaw-Kwasie, Abdur Razzaque Sarker

Research output: Contribution to journalArticlepeer-review


Background: Australia has a universal public healthcare system, but access to eHealth services (i.e. use of the
Internet and related technologies for healthcare services) remains a remarkable challenge, particularly in regional, rural and remote communities. Similar to many other countries, Australia faces the challenges of an
ageing population and chronic disease management as well as balancing the supply of and the demand for
quality healthcare and advanced medical procedures. The prima facie case for inequality in accessing eHealth
services across geographical settings is widely acknowledged. However, regional residents’ perceptions on access
to eHealth services lack empirical evidence. Therefore, this study empirically investigates the current state and
predictors of eHealth service access in regional Australia.
Methods: A cross-sectional questionnaire-based household survey was conducted within a total of 390 randomly
selected adults from the Western Downs Region in Southeast Queensland, Australia. Bivariate analysis was
conducted to examine the relationship between eHealth access and respondents’ characteristics. A multivariate
logistic regression model was also performed to identify the significant predictors of eHealth service access in
regional Australia.
Results: Approximately 78% of the households have access to eHealth services. However, access to eHealth
services in socioeconomically disadvantaged households was lower (19%) than that of their advantaged counterparts (25%). Factors that significantly increased the likelihood of accessing eHealth services included middle
age (odds ratio [OR] = 2.75, 95% confidence interval [CI]: 1.84, 8.66), household size (three to four members)
(OR = 2.29, 95% CI: 1.19, 4.73), broadband Internet access (OR = 1.67, 95% CI: 1.15, 2.90) and digital literacy
(OR = 2.39, 95% CI: 1.23, 4.59). Factors that negatively influenced access to eHealth services were low educational levels (OR = 0.28, 95% CI: 0.09, 0.61), low socioeconomic status (OR = 0.65, 95% CI: 0.28, 0.83) and
remote locations (OR = 0.66, 95% CI: 0.23, 0.80).
Conclusion: Emerging universal eHealth access provides immense societal benefits in regional settings. The
findings of this study could assist policy makers and healthcare practitioners in identifying factors that influence
eHealth access and thereby formulate effective health policies to optimise healthcare utilisation in regional
Original languageEnglish
Article number 103960
Number of pages9
JournalInternational Journal of Medical Informatics
Publication statusPublished - 1 Nov 2019
Externally publishedYes


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