Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States
Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States
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DOI：
10.1111/jrh.12228
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发表时间：
2018-02-01
影响因子：
4.9
通讯作者：
Hesse, Bradford W.
中科院分区：
文献类型：
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作者：
Greenberg, Alexandra J.;Haney, Danielle;Hesse, Bradford W.
卫生信息技术（HIT）的使用增加为患者参与和自我管理提供了新的机会。农村地区的患者尤其可以从更多的医疗保健工具和与提供者的电子通信中受益。我们评估了通过4 HIT工具随着时间的推移由农村或城市residence.MethodsAnalyses进行了使用数据从7迭代的国家癌症研究所的健康信息全国趋势调查（HINTS; 2003-2014）。农村/城市居住是基于美国农业部2003年的农村-城市连续体代码。感兴趣的结果包括在线管理个人健康信息;提供者是否保留电子健康记录（EHR）;向医疗保健提供者发送电子邮件;以及在线购买药品。双变量分析和Logistic回归被用来评估地理和结果之间的关系，控制sociodemographic characteristics.FindingsIn总数，6,043（17.6%，加权）的33,749名受访者在7个行政HINTS生活在农村地区。农村参与者报告经常上网的可能性较小（OR = 0.70，95%CI = 0.61-0.80）。与城市受访者相比，农村受访者报告其卫生保健提供者维护EHR的可能性既不高也不低;然而，他们在网上管理个人健康信息的几率却降低了，（OR = 0.59，95%CI = 0.40-0.78）和给医疗服务提供者发电子邮件（OR = 0.62，95%CI = 0.49-0.77）。需要进一步调查，以确定HIT使用的减少是否可能是由于缺乏互联网连接或对这些工具的认识。
PurposeThe increase in use of health information technologies (HIT) presents new opportunities for patient engagement and self-management. Patients in rural areas stand to benefit especially from increased access to health care tools and electronic communication with providers. We assessed the adoption of 4 HIT tools over time by rural or urban residency.MethodsAnalyses were conducted using data from 7 iterations of the National Cancer Institute's Health Information National Trends Survey (HINTS; 2003-2014). Rural/urban residency was based on the USDA's 2003 Rural-Urban Continuum Codes. Outcomes of interest included managing personal health information online; whether providers maintain electronic health records (EHRs); e-mailing health care providers; and purchasing medicine online. Bivariate analyses and logistic regression were used to assess relationships between geography and outcomes, controlling for sociodemographic characteristics.FindingsIn total, 6,043 (17.6%, weighted) of the 33,749 respondents across the 7 administrations of HINTS lived in rural areas. Rural participants were less likely to report regular access to Internet (OR = 0.70, 95% CI = 0.61-0.80). Rural respondents were neither more nor less likely to report that their health care providers maintained EHRs than were urban respondents; however, they had decreased odds of managing personal health information online (OR = 0.59, 95% CI = 0.40-0.78) and e-mailing health care providers (OR = 0.62, 95% CI = 0.49-0.77).ConclusionsThe digital divide between rural and urban residents extends to HIT. Additional investigation is needed to determine whether the decreased use of HIT may be due to lack of Internet connectivity or awareness of these tools.