Exploring the use of digital technology to deliver healthcare services with explicit consideration of health inequalities in UK settings: A scoping review

Albert Farre; Mei Fang; Beth Hannah; Meiko Makita; Alison McFadden; Deborah Menezes; Andrea Rodriguez; Judith Sixsmith; Nicola M Gray

doi:10.1177/20552076231185442

Exploring the use of digital technology to deliver healthcare services with explicit consideration of health inequalities in UK settings: A scoping review

Digit Health. 2023 Jun 29:9:20552076231185442. doi: 10.1177/20552076231185442. eCollection 2023 Jan-Dec.

Authors

Albert Farre¹, Mei Fang¹, Beth Hannah², Meiko Makita¹, Alison McFadden¹, Deborah Menezes³, Andrea Rodriguez⁴, Judith Sixsmith¹, Nicola M Gray¹

Affiliations

¹ School of Health Sciences, University of Dundee, Dundee, UK.
² School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK.
³ The Urban Institute, Heriot Watt University, Edinburgh, UK.
⁴ School of Dentistry, University of Dundee, Dundee, UK.

Abstract

Objective: To map and explore existing evidence on the use of digital technology to deliver healthcare services with explicit consideration of health inequalities in UK settings.

Methods: We searched six bibliographic databases, and the National Health Service (NHS) websites of each UK nation (England, Scotland, Wales, Northern Ireland). Restrictions were applied on publication date (2013-2021) and publication language (English). Records were independently screened against eligibility criteria by pairs of reviewers from the team. Articles reporting relevant qualitative and/or quantitative research were included. Data were synthesised narratively.

Results: Eleven articles, reporting data from nine interventions, were included. Articles reported findings from quantitative (n = 5), qualitative (n = 5), and mixed-methods (n = 1) studies. Study settings were mainly community based, with only one hospital based. Two interventions targeted service users, and seven interventions targeted healthcare providers. Two studies were explicitly and directly aimed at (and designed for) addressing health inequalities, with the remaining studies addressing them indirectly (e.g. study population can be classed as disadvantaged). Seven articles reported data on implementation outcomes (acceptability, appropriateness, and feasibility) and four articles reported data on effectiveness outcomes, with only one intervention demonstrating cost-effectiveness.

Conclusions: It is not yet clear if digital health interventions/services in the UK work for those most at risk of health inequalities. The current evidence base is significantly underdeveloped, and research/intervention efforts have been largely driven by healthcare provider/system needs, rather than those of service users. Digital health interventions can help address health inequalities, but a range of barriers persist, alongside a potential for exacerbation of health inequalities.

Keywords: Scoping review; United Kingdom; delivery of health care; digital technology; disadvantaged populations; health inequities.

Publication types

Review