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/amiajnl.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
作者调查了北方加州一个特征明确的糖尿病成人人群中基于互联网的患者门户网站kp.org的使用情况。在14102例不同的患者中，5671例（40%）请求患者门户的密码。其中，4311人（76%）激活了他们的账户，3922人（69%）登录了一次或多次患者门户网站; 2990人（53%）查看了实验室结果，2132人（38%）请求药物补充，2093人（37%）发送了电子邮件，835人（15%）进行了医疗预约。在对年龄、性别、种族/民族、移民身份、教育程度和就业状况进行调整后，与非西班牙裔高加索人相比，非洲裔美国人和拉丁美洲人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（与大学毕业生相比，OR 2.3（1.9至2.7））。那些糖尿病预后不良风险最高的人可能会进一步落后，因为卫生系统越来越依赖互联网，并限制了当前的访问和通信模式。
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.