# The Association Between Internet Use and Co-occurring Health Care Needs: Cross-Sectional Study in China

## TL;DR

This study explores how internet use in China is linked to multiple health care needs and suggests that health policies should adapt to these changing needs.

## Contribution

The study introduces a novel analysis of how internet use frequency correlates with co-occurring health care needs and identifies mediating factors like physical exercise and health status.

## Key findings

- 86.74% of participants had two or more co-occurring health care needs.
- Frequent internet use was positively associated with more co-occurring health care needs.
- Improved health status was negatively correlated with co-occurring health care needs.

## Abstract

The need for health care underpins health care service provision and serves as the foundation for enhancing service capacity and allocating resources. Health care needs are influenced by health, social, and economic conditions and may exhibit different characteristics over time. However, previous studies have primarily focused on specific populations or types of needs, overlooking the diversity and complexity of residents’ health care requirements. Furthermore, as informatization becomes a defining aspect of modern social development, the impact of internet utilization on the co-occurrence of health care needs remains unclear.

This study aims to determine the co-occurrence of health care needs among residents in China, explore the relationship between internet use frequency and co-occurring health care needs, and analyze the potential pathways of influence.

Data were obtained from the “Survey on Chinese Residents’ Health Services Needs in the New Era,” conducted from July to August 2018, yielding a sample of 12,513 individuals. An association rule learning algorithm was used to analyze the characteristics of co-occurring health care needs among Chinese residents, while a generalized linear model was used to examine the relationship between internet use frequency and co-occurring health care needs. Additionally, physical exercise and health status were selected as mediating variables, and their mediating effects were assessed using a path analysis model.

A substantial proportion of the surveyed population (8601/12,513, 68.74%) had 2 or more co-occurring health care needs, with a lower percentage among rural residents (4045/6053, 66.83%) compared with urban residents (4556/6460, 70.53%). Frequent internet users tended to have more co-occurring health care needs (β=.895, SE 0.019, P<.001). The results indicated a positive relationship between internet use frequency and both improved physical exercise (β=.121, P<.001) and health status (β=.026, P<.001). Notably, a high level of physical exercise was associated with an increase in co-occurring health care needs (β=.087, P<.001). By contrast, a significant negative correlation was observed between health status and co-occurring health care needs (β=-.787, P<.001), indicating that these needs decreased as health status improved.

The findings highlight the need for health policy makers and health care providers to address evolving health care needs and the impact of information technology on these needs. Furthermore, health care providers must adapt their services and delivery methods to meet residents’ co-occurring health care needs. Meanwhile, policy makers and service managers should ensure that service delivery keeps pace with residents’ changing needs through resource allocation, health insurance payment reforms, and performance incentives.