Urology Patients and the Internet: Socioeconomic Status and Language Skills Significantly Impact Use

Patient Internet use and resources are likely multifactorial. We assess how socioeconomic factors and language skills affect Internet use by patients.

We prospectively surveyed 116 patients with a bilingual questionnaire before they underwent urological surgery from July to September 2013. We obtained institutional review board approval for this study. Patients were surveyed for demographic data, English abilities, Internet use, anxiety level and understanding of the surgery.

Patients with low English abilities were significantly more likely to have lower incomes and education (p <0.05). In addition, patients with low English abilities were significantly more likely neither to have Internet access nor to have used it to research their surgery. On multivariate analysis those with low confidence in English were 2.8 times more likely not to have used the Internet to research their surgery when controlling for age. Increased age remained statistically associated with a lower likelihood of using the Internet even when controlling for all demographic data. Lastly, patients with low confidence in English were significantly less likely to report increased anxiety before surgery (OR 0.147) when controlling for all demographic data including ethnicity.

In our community those patients with low confidence in their English abilities are less likely to have access to, and use, the Internet before undergoing surgery. Older patients also use the Internet less often. Urologists should be aware of this potential language and age gap. Those with low English skills should likely be provided with additional counseling.