Disparities in Enrollment and Use of an Electronic Patient Portal
Disparities in Enrollment and Use of an Electronic Patient Portal
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DOI：
10.1007/s11606-011-1728-3
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发表时间：
2011-10-01
影响因子：
5.7
通讯作者：
Baker, David W.
中科院分区：
文献类型：
--
作者：
Goel, Mita Sanghavi;Brown, Tiffany L.;Baker, David W.
背景：随着对电子健康记录的有意义的使用的重视，患者门户网站可能变得越来越重要。很少有人知道病人登记，并使用，病人门户网站明确邀请后，从providers. substitutives：检查登记，并使用，电子病人门户网站的种族/民族，性别和年龄。设计：观察，横断面研究。参与者：在一个城市，2008年5月至2009年10月期间接受电子订单邀请其参与电子患者门户网站的学术初级保健实践。（a）在患者门户网站中登记，（B）在登记者中征求提供者建议，（c）在登记者中请求药物补充。关键结果：总体而言，在患者门户网站中登记的7，088名患者中有69%。所有少数民族患者入组的可能性明显低于白人：55%的黑人，64%的拉丁美洲人和66%的亚洲人，而白人为74%（所有成对比较的卡方p < 0.05）。这些差异在调整后的分析中仍然存在，尽管亚洲人的差异不再显著。此外，年龄最大的患者入组的可能性低于年龄最小的患者（调整后OR 0.79，95% CI 0.65-0.97）。虽然在入组者中使用患者门户网站没有种族/民族差异，但我们发现年龄和性别存在差异。在未校正和校正分析中，最年轻的患者征求提供者建议或要求药物补充的可能性明显低于任何其他年龄组。同样，男性患者不太可能征求供应商的意见比妇女在所有的analysis.CONCLUSION：大种族/民族的差异，在我们的患者门户网站注册。在入组者中，门户网站的使用按种族/民族相似，但按年龄或性别不同。未来扩大患者门户网站使用的努力需要解决这些差异的潜在机制，以确保该技术可用于不同的患者人群。
BACKGROUND: With emphasis on the meaningful use of electronic health records, patient portals are likely to become increasingly important. Little is known about patient enrollment in, and use of, patient portals after explicit invitation from providers.OBJECTIVES: To examine enrollment in, and use of, an electronic patient portal by race/ethnicity, gender and age.DESIGN: Observational, cross sectional study.PARTICIPANTS: Patients with attending physicians seen at one urban, academic primary care practice between May 2008 and October 2009 who received electronic orders inviting their participation in an electronic patient portal.MAIN MEASURES: (a) Enrollment in the patient portal, (b) Solicitation of provider advice among enrollees, (c) Requests for medication refills among enrollees.KEY RESULTS: Overall, 69% of 7,088 patients enrolled in the patient portal. All minority patients were significantly less likely to enroll than whites: 55% blacks, 64% Latinos and 66% Asians compared with 74% whites (chi-square p < 0.05 for all pairwise comparisons). These disparities persisted in adjusted analyses, although differences for Asians were no longer significant. In addition, the oldest patients were less likely to enroll than the youngest (adjusted OR 0.79, 95% CI 0.65-0.97). Although there were no racial/ethnic disparities in use of the patient portal among enrollees, we found differences by age and gender. The youngest patients were significantly less likely to solicit provider advice or request medication refills than any other age group in unadjusted and adjusted analyses. Similarly, male patients were less likely to solicit provider advice than women in all analyses.CONCLUSION: Large racial/ethnic disparities were seen in enrollment in our patient portal. Among enrollees, use of the portal was similar by race/ethnicity, but not by age or gender. Future efforts to expand use of the patient portal need to address potential mechanisms for these disparities to ensure this technology is accessible to diverse patient populations.