Use of e-health services between 1999 and 2002: A growing digital divide
Use of e-health services between 1999 and 2002: A growing digital divide
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DOI：
10.1197/jamia.m1672
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发表时间：
2005-03-01
影响因子：
6.4
通讯作者：
Ortiz, E
中科院分区：
文献类型：
--
作者：
Hsu, J;Huang, J;Ortiz, E
目的：评估四年内电子医疗的使用模式和用户特征。设计：对预付费综合交付系统成员进行纵向、基于人群的研究（1999-2002）。可用的电子医疗服务包括订购处方药补充、安排预约和询问医疗问题。测量：已知的电子医疗服务获取率以及每个季度的电子医疗使用率。结果：已知拥有电子医疗服务的成员数量从 1999 年的 51,336 人 (1.6%) 增加到 2002 年的 324,522 人 (9.3%)。 家庭中至少有一个人拥有电子医疗服务的家庭百分比访问率从 2.7% 增加到 14.1%。在已知访问权限的受试者中，至少使用过一次电子医疗服务的受试者百分比从 1999 年的 25.7% 增加到 2002 年的 36.2%。在多变量分析中，预期临床需求较低、非白人或生活在低社会经济地位 (SES) 社区的受试者在 2002 年使用电子医疗服务的可能性较小。电子医疗并随着时间的推移而扩大。结论：电子医疗服务的获取和使用正在迅速增长。医疗需求较多的人群似乎最常使用这些服务。然而，大多数受试者不使用任何电子医疗服务。需要更多的研究来确定电子医疗使用因种族/民族和社会经济地位差异的潜在原因，以及这些差异对临床结果的影响。
Objective: To evaluate the patterns of e-Health use over a four-year period and the characteristics of users.Design: Longitudinal, population-based study (1999-2002) of members of a prepaid integrated delivery system. Available e-Health services included ordering prescription drug refills, scheduling appointments, and asking medical questions.Measurements: Rates of known access to e-Health services, and of e-Health use each quarter.Results: The number of members with known e-Health access increased from 51,336 (1.6%) in 1999 to 324,522 (9.3%), in 2002. The percentage of households in which at least one person in the household had access increased from 2.7% to 14.1%. Among the subjects with known access, the percentage of subjects that used e-Health at least once increased from 25.7% in 1999 to 36.2% in 2002. In the multivariate analysis, subjects who had a low expected clinical need, were nonwhite, or lived in low socioeconomic status (SES) neighborhoods were less likely to have used e-Health services in 2002. Disparities by race/ethnicity and SES persisted after controlling for access to e-Health and widened over time.Conclusion: Access to and use of e-Health services are growing rapidly. Use of these services appears to be greatest among persons with more medical need. The majority of subjects, however, do not use any e-Health services. More research is needed to determine potential reasons for disparities in e-Health use by race/ethnicity and SES as well as the implications of these disparities on clinical outcomes.