Integrated Care Programs for People with Multimorbidity in European Countries: eHealth Adoption in Health Systems
Table 4
Benefits and barriers of/for adopting eHealth tools (at least one) included in the programs by health system characteristics of countries (% agreeing in the programs)a.
Benefits/barriers of/for using eHealth tools
National health model
value
Strength of PC
value
Level of(de)centralization
value
All programs % ()
NHS % ()
SIS/TC % ()
Strong/medium % ()
Weak % ()
Decentralized % ()
Centralized % ()
Benefits
Management of care
92.9 (39)
100.0 (16)
0.272
94.7 (36)
94.7 (18)
1.000
94.6 (35)
95.5 (21)
0.884
94.9 (56)
Integration of care
90.5 (38)
100.0 (16)
0.201
92.1 (35)
94.7 (18)
0.714
91.9 (34)
95.5 (21)
0.599
93.2 (55)
Quality of care
81.0 (34)
100.0 (16)
0.060
89.5 (34)
78.9 (15)
0.281
89.2 (33)
81.8 (18)
0.424
86.4 (51)
Cost efficiency
76.2 (32)
81.3 (13)
0.680
76.3 (29)
73.7 (14)
0.828
73.0 (27)
81.8 (18)
0.440
76.3 (45)
Quality of life
69.0 (29)
75.0 (12)
0.656
65.8 (25)
73.7 (14)
0.546
64.9 (24)
77.3 (17)
0.317
69.5 (41)
Barriers
Inadequate funding
61.5 (24)
55.6 (10)
0.669
47.4(18)
83.3 (15)
0.011
42.9 (15)
87.0 (20)
0.001
60.3 (35)
Compatibility between different eHealth tools
53.8 (21)
55.6 (10)
0.904
50.0 (19)
61.1 (11)
0.436
48.6 (17)
65.2 (15)
0.212
55.2 (32)
Inadequate technical ICT support
53.8 (21)
61.1 (11)
0.607
42.1 (16)
77.8 (14)
0.012
40.0 (14)
78.3 (18)
0.004
55.2 (32)
Inadequate ICT infrastructures
56.4 (22)
50.0 (9)
0.652
44.7 (17)
66.7 (12)
0.125
42.9 (15)
69.6 (16)
0.046
53.4 (31)
Lack of skills among patients
46.2 (18)
61.1 (11)
0.294
44.7 (17)
61.1 (11)
0.252
40.0 (14)
69.6 (16)
0.028
51.7 (30)
Inadequate legislative framework
48.7 (19)
55.6 (10)
0.631
36.8 (14)
72.2 (13)
0.013
40.0 (14)
65.2 (15)
0.060
50.0 (29)
Lack of skills among providers
35.9 (14)
66.7 (12)
0.030
44.7 (17)
38.9 (7)
0.680
37.1 (13)
56.5 (13)
0.147
44.8 (26)
Uncertainty of cost efficiency
30.8 (12)
55.6 (10)
0.074
26.3 (10)
61.1 (11)
0.012
28.6 (10)
56.5 (13)
0.033
39.7 (23)
Privacy issues
23.1 (9)
61.1 (11)
0.005
21.1 (8)
55.6 (10)
0.010
22.9 (8)
52.2 (12)
0.022
34.5 (20)
Resistance by care providers
20.5 (8)
55.6 (10)
0.008
34.2 (13)
22.2 (4)
0.362
25.7(9)
43.5 (10)
0.159
32.8 (19)
Cultural resistance
17.9 (7)
38.9 (7)
0.088
28.9 (11)
11.1 (2)
0.140
25.7(9)
26.1 (6)
0.975
25.9 (15)
Resistance by patients
15.4 (6)
38.9 (7)
0.049
18.4 (7)
22.2 (4)
0.738
28.6 (10)
13.0 (3)
0.165
22.4 (13)
aMultiple answers/agreeing were allowed. Data were analysed as % of agreeing vs % of disagreeing for each benefit/barrier in the programs.