Internet use and health: Connecting secondary data through spatial microsimulation

Abstract

Objective Internet use may affect health and health service use,and is seen as a potential lever for empowering patients,levelling inequalities and managing costs in the health system.However, supporting evidence is scant, partially due to a lackof data to investigate the relationship on a larger scale. Thispaper presents an approach for connecting existing datasets togenerate new insights. Methods Spatial microsimulation offers away to combine a random sample survey on Internet use withaggregate census data and other routine data from the healthsystem based on small geographic areas to examine therelationship between Internet use, perceived health and healthservice use. While health research has primarily used spatialmicrosimulation to estimate the geographic distribution of acertain phenomenon, this research highlights this simulationtechnique as a way to link datasets for joint analysis, withlocation as the connecting element. Results Internet use isassociated with higher perceived health and lower health serviceuse independently of whether Internet use was conceptualised interms of access, support or usage, and controlling forsociodemographic covariates. Internal validation confirms thatdifferences between actual and simulated data are small;external validation shows that the simulated dataset is a goodreflection of the real world. Conclusion Spatial microsimulationhelps to generate new insights through linking secondary data ina privacy-preserving and cost-effective way. This allows forbetter understanding the relationship between Internet use andhealth, enabling theoretical insights and practical implicationsfor policy with insights down to the local level.