How do health authorities inform about general practitioner selection? Analysis of Italian Websites

BACKGROUND: The Next Generation EU and Italian Recovery and Resilience Plan share the common goal of supporting digital transformation. In health, adequate digitalization and web communication strategies are essential to achieve adequate population health outcomes. This work describes the level of digitalization and information of a fundamental primary care service: the choice or change of the General Practitioner (GP). METHODS: The analysis was conducted by consulting websites of Italian Local Health Authorities (LHAs). First, we explored digitalization levels of 105 websites through the Primary Care Digital Information (PCDI) composite index. It comprises four dimensions: informativeness, accessibility, inclusiveness, and adaptability, scoring from 0-5 (low-high digitalization). Second, we conducted a readability analysis of websites. Text quality was measured using the Gulpease and READ-IT indexes and New Basic Italian Vocabulary (NBIV) was used for lexical complexity. RESULTS: We found a national average of 2,48 for the PCDI (Min 0 - Max 4,38). Nationally, the best performing dimension was adaptability, while the worst was inclusiveness. Half of the LHAs provided several digital alternatives to choose or change the GP, while the remaining provided limited or no options. Most LHAs (70%) displayed directly on their home page a reference on how citizens can choose or change GP. However, 70% lacked specific information for non-residents citizens. Regarding readability, the national average was 48,78 for READ-IT (Min 32 - Max 62), on a scale from 0-100 (good-bad readability). CONCLUSIONS: Overall, our findings depict variable and fragmented digitalization and information levels of a key health service. Despite best practices, several areas require monitoring and intervention. Moreover, some barriers characterize Italian health communication strategies, notably the variability of information across and within regions and on average low website readability. KEY MESSAGES: • There are significant digitalization discrepancies in Italy with respect to the primary care service observed. The PCDI scores highlight a fragmented scenario and opportunities for improvement. • The aspects related to the readability of information remain to be monitored. This study highlights the need to invest more in fostering efficient service comprehension and clarity.