Digital divide in eHealth: Sociodemographic determinants of access in Spain

This study analyses access to and use of eHealth services in Spain from a multidimensional perspective, considering how sociodemographic factors such as age, gender, educational level, income, nationality and place of residence influence digital divide in health. The digitalisation of public services has generated new opportunities, but it has also accentuated structural inequalities in access to key eHealth tools. Specifically, this study focuses on three components: the Digital Health Record (DHR), electronic prescriptions and digital certificate.

This research is based on a quantitative approach, using data from the three waves of the Health Barometer 2024 of the Centro de Investigaciones Sociológicas-CIS-with a total sample of 7.623 cases. Binary logistic regression models were applied to identify which variables predict the accessibility and usability of these services.

The results show that variables such as age, gender, educational level, income, employment status, nationality, place of residence and health status have a significant impact on the probability of using eHealth tools. Especially older people, people with less education or low economic resources present greater barriers, which would evidence a structural and multidimensional digital divide.

This study suggests that the digitalisation of the healthcare system may reinforce existing inequalities. Particularly those associated with the factors that showed the greatest influence on access to and use of digital health services in the analysis, such as age, income and educational level. These findings highlight the need for inclusive digital health policies that address the multidimensional nature of digital divide.