Racial and Ethnic Disparities in Health Information Technology Use and Associated Trends among Individuals Living with Chronic Diseases
Racial and Ethnic Disparities in Health Information Technology Use and Associated Trends among Individuals Living with Chronic Diseases
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DOI：
10.1089/pop.2021.0055
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发表时间：
2021-05-14
影响因子：
2.5
通讯作者：
Adepoju，Omolola E.
中科院分区：
文献类型：
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作者：
Ojinnaka，Chinedum O.;Adepoju，Omolola E.
健康信息技术（HIT）可以提高慢性病患者获得和利用最佳卫生保健的机会。本研究旨在提供慢性病患者中HIT使用的种族/民族差异以及相关趋势的人群水平信息。研究样本包括2011-2018年国家健康访谈调查的成年受访者（≥18岁），他们至少患有1种慢性疾病。使用二项式回归分析人种/种族、年份和患者-提供者互动中HIT使用的4项指标之间的相关性。使用回归参数估计值预测人种/种族间结局变量的概率趋势。大约73%的研究样本是非西班牙裔白人，15%是非西班牙裔黑人，13%是西班牙裔。与非西班牙裔白人相比，非西班牙裔黑人（OR = 0.72; 95% CI = 0.67，0.76）和西班牙裔（OR = 0.78; 95% CI = 0.72，0.84）中使用任何HIT的调整后几率降低。使用任何HIT的可能性随着年份的增加而增加（OR：1.16; 95%CI = 1.15，1.18）。与在线预约相比，与提供者进行电子邮件通信和在线处方续药的种族/民族差异趋势更大。COVID-19大流行导致HIT在患者护理方面的采用或扩展加快。在非西班牙裔黑人和西班牙裔美国人中有限使用HIT可能会加重该亚群所经历的不成比例的慢性疾病负担、次优临床结局和可预防的医疗保健费用。总之，有必要进行有意的和战略性的人口层面的干预措施，以增加HIT的采用和非西班牙裔黑人和西班牙裔慢性病患者之间的使用。
Health information technology (HIT) can enhance optimal health care access and utilization among individuals living with chronic diseases. This study aimed to provide population-level information on racial/ethnic disparities in HIT use and associated trends among those living with chronic diseases. The study sample consisted of adult respondents (≥18 years) of the 2011–2018 National Health Interview Survey living with at least 1 chronic condition. Binomial regression was used to analyze the association between race/ethnicity, year, and 4 measures of HIT use for patient-provider interaction. Regression parameter estimates were used to predict the trends in probability of the outcome variables across race/ethnicity. About 73% of the study sample were non-Hispanic Whites, 15% were non-Hispanic Blacks, and 13% were Hispanics. Compared to non-Hispanic Whites, there were decreased adjusted odds of any HIT use among non-Hispanic Blacks (OR = 0.72; 95% CI = 0.67, 0.76) and Hispanics (OR = 0.78; 95% CI = 0.72, 0.84). The likelihood of any HIT use increased with increasing year (OR: 1.16; 95% CI = 1.15, 1.18). Trends in racial/ethnic disparities were wider for email communication with provider and online prescription refill compared to online scheduling of appointment. The COVID-19 pandemic has led to accelerated adoption or expansion of HIT for patient care. Limited HIT use among non-Hispanic Blacks and Hispanics could worsen the disproportionate chronic disease burden, suboptimal clinical outcomes, and preventable health care costs experienced by this subpopulation. In conclusion, there is a need for intentional and strategic population-level interventions to increase HIT adoption and use among non-Hispanic Blacks and Hispanics living with chronic diseases.