Citizens' Use of eHealth Services During COVID-19 in Relation to National Policy Goals

The main goals of the Swedish eHealth strategy are to enable citizens to achieve good and equal health and welfare, and to support self-determination and increased participation in society. We analyzed the relationship between these goals and the use of eHealth services offered for citizens prior to and during the COVID-19 pandemic. Data was collected through a national citizen survey issued in 2019 and 2021 to a sample size of 15.000 representative individuals each. Results showed that the use of eHealth services was highest in the 30-49 years age group and among respondents with high education. There were no major differences between respondents with high, medium, or low income, and neither between respondents with different degrees of self-perceived health, nor between native Swedish and non-Swedish respondents. Changes in use of different eHealth services over time were most probably related to the pandemic and are not significant. All age groups showed a similar relative increase regarding their use of eHealth services, except when searching the Internet for diagnosis and treatment where persons above 75 years of age had the largest increase. Most significant were the increase in online visits and the decrease in maintaining health, training, or food diaries. Strategic goals related to equity seem to be partly met as eHealth services are used to the same degree by different socio-economic groups. However, the older population uses eHealth services less than other age groups and a deeper understanding of the relationship between specific services and their impact on strategic goals is needed.