Patient portals and broadband internet inequality
Patient portals and broadband internet inequality
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DOI：
10.1093/jamia/ocx020
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发表时间：
2017-09-01
影响因子：
6.4
通讯作者：
Einstadter, Douglas
中科院分区：
文献类型：
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作者：
Perzynski, Adam T.;Roach, Mary Joan;Einstadter, Douglas
背景：患者门户网站已显示出提高医疗质量和效率的潜力。互联网接入和其他影响患者门户网站使用的因素可能会恶化health disparities.Methods：观察性研究2012年至2015年1次或多次访问城市公共卫生保健系统门诊的成年人。我们使用混合效应逻辑回归来评估宽带互联网接入与（1）患者门户启动之间的关联（患者是否至少登录1次）和（2）消息传递，控制人口统计学和邻居特征。在2012-2015年期间，有243248名成年人接受了1次或多次访视，70835名（29.1%）开始使用门户网站。白人、黑人和西班牙裔患者的门静脉启动率分别为34.1%、23.4%和23.8%，医疗补助（26.5%）、医疗保险（23.4%）和无保险患者（17.4%）低于商业保险患者（39.3%）。在多变量分析中，开始使用门静脉（比值比[OR] = 1.24/五分位数，95%置信区间[CI]，1.23-1.24，P
Background: Patient portals have shown potential for increasing health care quality and efficiency. Internet access and other factors influencing patient portal use could worsen health disparities.Methods: Observational study of adults with 1 or more visits to the outpatient clinics of an urban public health care system from 2012 to 2015. We used mixed effects logistic regression to evaluate the association between broadband internet access and (1) patient portal initiation (whether a patient logged in at least 1 time) and (2) messaging, controlling for demographic and neighborhood characteristics.Results: There were 243 248 adults with 1 or more visits during 2012-2015 and 70 835 (29.1%) initiated portal use. Portal initiation was 34.1% for whites, 23.4% for blacks, and 23.8% for Hispanics, and was lower for Medicaid (26.5%), Medicare (23.4%), and uninsured patients (17.4%) than commercially insured patients (39.3%). In multivariate analysis, both initiation of portal use (odds ratio [OR] = 1.24 per quintile, 95% confidence interval [CI], 1.23-1.24, P