Disparities in patient portal access and the role of providers in encouraging access and use
Disparities in patient portal access and the role of providers in encouraging access and use
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DOI：
10.1093/jamia/ocac227
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发表时间：
2022-11-30
影响因子：
6.4
通讯作者：
Patel, Vaishali
中科院分区：
文献类型：
--
作者：
Richwine, Chelsea;Johnson, Christian;Patel, Vaishali
目的 本研究的目的是确定患者门户提供、访问和使用方面的种族和民族差异，并通过提供患者门户并鼓励其使用来检验提供商在促进电子健康信息 (EHI) 访问方面的作用。材料和方法使用 2019 年和 2020 年的全国代表性调查数据 (N = 8028)，我们检查了由其提供商提供访问门户的患者的差异以及随后访问和使用的差异。使用多变量模型，我们估计了种族和族裔对被提供、访问或使用门户的可能性的影响。在提供的这些内容中，我们研究了提供商鼓励与门户访问之间的关系；对于那些没有访问其门户网站的人，我们探讨了不使用的原因。结果 黑人和西班牙裔个人获得和访问患者门户的比率明显低于白人。与白人相比，黑人和西班牙裔获得门户网站的可能性低 5.2 个百分点 (P < .05)，而在提供的门户网站中，访问门户网站的可能性低 7.9 个百分点 (P < .05)。获得并访问门户网站的黑人和西班牙裔人使用门户网站下载或传输信息的可能性比白人高 12 个百分点 (P < .01)。获得门户网站并鼓励其使用的个人访问该门户的可能性高出 21 个百分点。讨论 患者门户访问和使用的差异可能是由报告提供门户的患者群体的差异造成的。结论 提供商通过促进患者门户的访问，在增加 EHI 的访问方面发挥着重要作用。
Objective The aim of this study was to identify racial and ethnic disparities in patient portal offers, access, and use and to examine the role of providers in facilitating access to electronic health information (EHI) by offering patient portals and encouraging their use. Materials and Methods Using nationally representative survey data from 2019 and 2020 (N = 8028), we examined disparities in patients being offered access to a portal by their provider and differences in subsequent access and use. Using multivariable models, we estimated the effect of race and ethnicity on the likelihood of being offered, accessing or using a portal. Among those offered, we examined the relationship between provider encouragement and portal access; and for those who did not access their portal, we explored reasons for nonuse. Results Black and Hispanic individuals were offered and accessed patient portals at significantly lower rates than White individuals. Compared to Whites, Black and Hispanic individuals were 5.2 percentage-points less likely to be offered a portal (P < .05) and, among those offered, 7.9 percentage-points less likely to access their portal (P < .05). Black and Hispanic individuals who were offered and accessed a portal were 12 percentage-points more likely than Whites to use it to download or transmit information (P < .01). Individuals who were offered a portal and encouraged to use it were 21 percentage-points more likely to access it. Discussion Differences in patient portal access and use are likely driven by disparities in which groups of patients reported being offered a portal. Conclusions Providers play an important role in increasing access to EHI by facilitating access to patient portals.