Evidence Summary


Health Sciences Patrons Use Electronic Books More than Print Books


A Review of:

Li, J. (2016). Is it cost-effective to purchase print books when the equivalent e-book is available? Journal of Hospital Librarianship, 16(1), 40-48. http://dx.doi.org/10.1080/15323269.2016.1118288


Reviewed by:

Robin E. Miller

Associate Professor and Research & Instruction Librarian

McIntyre Library

University of Wisconsin-Eau Claire

Eau Claire, Wisconsin, United States of America 

Email: millerob@uwec.edu


Received: 22 May 2017  Accepted: 11 July 2017



cc-ca_logo_xl 2017 Miller. This is an Open Access article distributed under the terms of the Creative CommonsAttributionNoncommercialShare Alike License 4.0 International (http://creativecommons.org/licenses/by-nc-sa/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly attributed, not used for commercial purposes, and, if transformed, the resulting work is redistributed under the same or similar license to this one.





Objective – To compare use of books held simultaneously in print and electronic formats.


Design – Case study.


Setting – A health sciences library at a public comprehensive university with a medical college in the southern United States of America.


Subjects – Usage data for 60 books held by the library simultaneously in print and electronically. The titles were on standing order in print and considered “core” texts for clinical, instructional, or reference for health sciences faculty, students, and medical residents.


Methods – Researchers collected usage data for 60 print titles from the integrated library system and compared the data to COUNTER reports for electronic versions of the same titles, for the period spanning 2010-2014.


Main Results – Overall, the 60 e-book titles were used more than the print versions, with the electronic versions used a total of 370,695 times while the print versions were used 93 times during the time period being examined.


Conclusion – The use of electronic books outnumbers the use of print books of the same title.




The title of the article suggests that the author may offer a method for determining whether it is “cost-effective” to purchase both the print and electronic versions of the same book title. The sole method employed is to compare raw usage statistics between print and electronic versions of the same 60 titles. The author does not discuss other factors that may influence “cost-effectiveness,” including cost of print titles versus cost to license electronic titles, which is often substantially greater. The article does not include a discussion of other aspects of e-book costs, including platform fees, total cost of vendor-selected e-book packages, or terms and conditions that limit simultaneous use or that require repurchase of an electronic title after a defined number of uses.


Comparing the use of the electronic and print versions of a collection of books may demonstrate that patrons of this health sciences library prefer electronic formats as compared to print. However, the researcher does not define “use” for electronic or print content. Electronic use may constitute full downloads, chapter downloads, printing, online reading, or another form of use often articulated by vendor usage reports. The article also provides no evidence that comparing electronic usage and print usage is a valid method. The reported statistics do not control for variables that may influence the user’s choice to access e-books, such as instant access to the full-text in a discovery layer, direct links to electronic content in syllabi, or library location.


Computational errors compromise the conclusions of this article. The author states, “[t]otal electronic book usage was 99.7% versus 0.03% print book usage” (p. 44), though these percentages do not add up to 100% and what they relate to is not stated clearly. The article reports 93 uses of print titles and 370,695 uses of e-book titles. Total use of the print and electronic subjects equals 370,788; however, 0.03% of 370,788 does not equal 93 and 99.7% does not equal 370,695.


The author argues that libraries must respond to the rise of devices like Kindle and e-book applications offered by various publishers and database vendors, which have rendered e-books more attractive to library users. Library practitioners may agree with this argument; however, this article does not provide evidence to support that assertion because the results do not delineate e-book usage by mode or device of access.


For the collection development practitioner, this study may offer insight about whether it is necessary to provide print and electronic access to material in core instructional or reference collections. However, the author compared usage of 60 titles that have clearly been identified by librarians and faculty as valuable to the patron population. In contrast, 250,000 electronic books were available in the author’s library at the time of publication. The results of this study would be more compelling if the research included a larger sample of titles held in both formats, and if the analysis also incorporated other factors that librarians typically use to make collection development decisions, particularly cost.