Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access
Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access
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DOI：
10.1136/jamia.2010.006015
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发表时间：
2011-05-01
影响因子：
6.4
通讯作者：
Schillinger, Dean
中科院分区：
文献类型：
--
作者：
Sarkar, Urmimala;Karter, Andrew J.;Schillinger, Dean
作者调查了北加州一群特征明确的成人糖尿病患者对基于互联网的患者门户网站 kp.org 的使用情况。在 14,102 名不同的患者中，5671 名 (40%) 要求输入患者门户密码。其中，4311 人（76%）激活了账户，3922 人（69%）登录患者门户一次或多次； 2990 名 (53%) 参与者查看了实验室结果，2132 名 (38%) 名参与者要求补充药物，2093 名 (37%) 名参与者发送了电子邮件，835 名 (15%) 名参与者进行了医疗预约。在调整年龄、性别、种族/族裔、移民身份、教育程度和就业状况后，与非西班牙裔白种人相比，非裔美国人和拉丁裔从未登录的几率更高（OR 2.6（2.3至2.9）；OR 2.3（1.9至2.6）），没有教育学位的人也是如此（OR与大学毕业生相比，2.3（1.9至2.7））。随着卫生系统越来越依赖互联网并限制当前的访问和通信模式，那些最有可能患糖尿病不良结果的人可能会进一步落后。
The authors investigated use of the internet-based patient portal, kp.org, among a well-characterized population of adults with diabetes in Northern California. Among 14 102 diverse patients, 5671 (40%) requested a password for the patient portal. Of these, 4311 (76%) activated their accounts, and 3922 (69%), logged on to the patient portal one or more times; 2990 (53%) participants viewed laboratory results, 2132 (38%) requested medication refills, 2093 (37%) sent email messages, and 835 (15%) made medical appointments. After adjustment for age, gender, race/ethnicity, immigration status, educational attainment, and employment status, compared to non-Hispanic Caucasians, African Americans and Latinos had higher odds of never logging on (OR 2.6 (2.3 to 2.9); OR 2.3 (1.9 to 2.6)), as did those without an educational degree (OR compared to college graduates, 2.3 (1.9 to 2.7)). Those most at risk for poor diabetes outcomes may fall further behind as health systems increasingly rely on the internet and limit current modes of access and communication.