Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study.
Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study.
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DOI：
10.2196/18870
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发表时间：
2020-09-17
影响因子：
7.4
通讯作者：
Shea CM
中科院分区：
文献类型：
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作者：
Turner K;Clary A;Hong YR;Alishahi Tabriz A;Shea CM
过去对患者门户采用障碍的研究是在少数患者和医疗保健环境中进行的，这限制了推广。这项研究有以下两个目标：(1)评估患者门户采用障碍在未采用者中的流行率；(2)在具有全国代表性的样本中，检查未采用者特征与报告障碍之间的关联。这项研究的数据来自2019年健康信息全国趋势调查。我们计算描述性统计来确定最普遍的障碍，并进行多变量Logistic回归分析，以检查哪些特征与报告的障碍相关。样本包括4815名个体。其中，2828人(58.73%)没有采用患者门户。在未采用者(n=2828)中，最常见的障碍是患者倾向于面对面交流(1810/2828，64.00%)，不认为需要患者门户(1385/2828，48.97%)，以及缺乏舒适度和使用计算机的经验(735/2828，25.99%)。不太常见的是，个人报告没有患者门户(650/2828，22.98%)，没有互联网接入(650/2828，22.98%)，隐私问题(594/2828，21.00%)，登录困难(537/2828，18.99%)，以及多个患者门户(255/2828，9.02%)作为障碍。与女性相比，男性倾向于直接与提供者交谈的几率显著降低(优势比[OR]0.75，95%CI 0.60-0.94；P=0.01)。年龄较大(OR 1.01，95%CI 1.00-1.02；P<；.001)、患有慢性病(OR 1.83，95%CI 1.44-2.33；P<；.001)和收入低于20,000美元(OR 1.61，95%CI 1.11-2.34；P=.01)与表明倾向于直接与提供者交谈呈正相关。与非西班牙裔个体相比，西班牙裔个体表明他们不需要患者门户的几率显著更高(OR 1.59，95%可信区间1.24-2.05；P<；.001)。年龄较大的人(OR 1.05，95%CI 1.04-1.06；P<；.001)、高中文凭以下的个人(OR 3.15，95%CI 1.79-5.53；P<；.001)和家庭收入低于20,000美元的个人(OR 2.78，95%CI 1.88-4.11；P<；.001)表示他们对电脑不舒服的几率明显更高。患者门户采用的最常见障碍是更喜欢面对面交流，不需要患者门户，以及对计算机感到不舒服，这些障碍是可以修改和干预的。患者特征可以帮助预测哪些患者在采用患者门户时最有可能遇到某些障碍。还需要进一步的研究，以根据患者的需求和偏好定制实施方法。
Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; P=.01). Older age (OR 1.01, 95% CI 1.00-1.02; P<.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; P<.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; P=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; P<.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; P<.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; P<.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; P<.001) had significantly higher odds of indicating that they were uncomfortable with a computer. The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.
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影响因子：
7.4
作者：
Hoogenbosch B;Postma J;de Man-van Ginkel JM;Tiemessen NA;van Delden JJ;van Os-Medendorp H
通讯作者：
van Os-Medendorp H
影响因子：
9.7
作者：
Anthony, Denise L.;Campos-Castillo, Celeste;Lim, Paulina S.
通讯作者：
Lim, Paulina S.
影响因子：
7.4
作者：
Bailey, Stacy Cooper;Wallia, Amisha;Wolf, Michael S.
通讯作者：
Wolf, Michael S.
影响因子：
4.9
作者：
Eden KB;Totten AM;Kassakian SZ;Gorman PN;McDonagh MS;Devine B;Pappas M;Daeges M;Woods S;Hersh WR
通讯作者：
Hersh WR
DOI：
10.13063/2327-9214.1281
发表时间：
2017-04-20
期刊：
EGEMS (Washington, DC)
影响因子：
--
作者：
Arcia, Adriana
通讯作者：
Arcia, Adriana