The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE).
The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system-results from the diabetes study of northern California (DISTANCE).
复制标题
DOI：
10.1080/10810730.2010.499988
复制
发表时间：
2010
影响因子：
4.4
通讯作者：
Schillinger D
中科院分区：
文献类型：
--
作者：
Sarkar U;Karter AJ;Liu JY;Adler NE;Nguyen R;Lopez A;Schillinger D
基于互联网的患者门户网站旨在改善访问和质量，并将在医疗保健中发挥越来越重要的作用，特别是对于糖尿病和其他慢性病。健康素养有限的糖尿病患者的健康结果更差，有限的健康素养可能是有效利用基于互联网的健康获取服务的障碍。我们调查了一个基于互联网的患者门户网站在一个特征良好的成人糖尿病患者群体中的使用。我们估计健康素养使用三个验证自我报告项目。我们探讨了健康素养和基于互联网的患者门户网站的使用之间的独立关联，调整了年龄，性别，种族/民族，教育程度和收入。在14，102名受试者（28%为非西班牙裔白色人、14%为拉丁裔人、21%为非洲裔美国人、9%为亚裔人、12%为菲律宾人、17%为多种族或其他族裔）中，6099名（62%）受试者报告了健康素养方面的一些限制，5671名（40%）受试者完成了患者门户注册。在调整后的分析中，与没有报告任何健康素养限制的人相比，健康素养有限的人从未登录患者门户网站的几率更高（OR 1.7，1.4至1.9）。即使在那些有互联网接入的人中，健康素养和患者门户网站使用之间的关系也持续存在（OR 1.4，95% CI 1.2至1.8）。报告健康素养有限的糖尿病患者与健康素养足够的患者相比，不太可能访问和浏览基于互联网的患者门户网站。虽然互联网有潜力极大地扩大卫生保健系统的能力和覆盖面，但目前的使用模式表明，在缺乏涉及健康素养有限的人的参与性设计工作的情况下，如果卫生系统越来越依赖基于互联网的服务，那些最有可能出现不良糖尿病健康结果的人将进一步落后。
Internet-based patient portals are intended to improve access and quality, and will play an increasingly important role in health care, especially for diabetes and other chronic diseases. Diabetes patients with limited health literacy have worse health outcomes, and limited health literacy may be a barrier to effectively utilizing internet-based health access services. We investigated use of an internet-based patient portal among a well characterized population of adults with diabetes. We estimated health literacy using three validated self-report items. We explored the independent association between health literacy and use of the internet-based patient portal, adjusted for age, gender, race/ethnicity, educational attainment, and income. Among 14,102 participants (28% non-Hispanic White, 14% Latino, 21% African-American, 9% Asian, 12% Filipino, and 17% multiracial or other ethnicity), 6099 (62%) reported some limitation in health literacy, and 5671 (40%) respondents completed registration for the patient portal registration. In adjusted analyses, those with limited health literacy had higher odds of never signing on to the patient portal (OR 1.7, 1.4 to 1.9) compared with those who did not report any health literacy limitation. Even among those with internet access, the relationship between health literacy and patient portal use persisted (OR 1.4, 95% CI 1.2 to 1.8). Diabetes patients reporting limited health literacy were less likely to both access and navigate an internet-based patient portal than those with adequate health literacy. Although the internet has potential to greatly expand the capacity and reach of health care systems, current use patterns suggest that, in the absence of participatory design efforts involving those with limited health literacy, those most at risk for poor diabetes health outcomes will fall further behind if health systems increasingly rely on internet-based services.
登录
查看更多内容
影响因子：
2.9
作者：
Morris, Nancy S;MacLean, Charles D;Littenberg, Benjamin
通讯作者：
Littenberg, Benjamin
影响因子：
5.7
作者：
Chew, Lisa D.;Griffin, Joan M.;VanRyn, Michelle
通讯作者：
VanRyn, Michelle
DOI：
10.1197/jamia.m1672
发表时间：
2005-03-01
影响因子：
6.4
作者：
Hsu, J;Huang, J;Ortiz, E
通讯作者：
Ortiz, E
影响因子：
168.9
作者：
HART, JT
通讯作者：
HART, JT
影响因子：
16.2
作者：
Mulvaney, Shelagh A.;Rothman, Russell L.;Dietrich, Mary S.
通讯作者：
Dietrich, Mary S.