Disparities in Patient Portal Activation and Usage at a Large Pediatric Academic Institution.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-11-04 DOI:10.1007/s40615-024-02009-w
Ethan G Chuang, Andrew C Richardson, Zaineb Boulil, Cynthia L Kuelbs, Jeannie S Huang
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Abstract

Background and objective: Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children.

Methods: We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status.

Results: Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates.

Discussion: Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income.

Conclusion: Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.

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一家大型儿科学术机构在患者门户激活和使用方面的差异。
背景和目的:获取个人医疗信息可促进患者对健康问题的了解,并使患者能够自我倡导医疗保健需求。电子病历系统的出现和 2016 年《21 世纪 CURES 法案》促进并鼓励患者获取个人医疗信息,但依赖技术的模式往往使某些社区处于不利地位。我们试图评估本机构在访问患者门户网站方面是否存在差异,本机构是一个服务 100 万儿童地区的主要儿科医疗机构:我们评估了本机构过去十年(2010-2021 年)患者门户网站账户的激活情况。我们根据种族背景、语言偏好和主要家庭访问地点提供的收入信息对门户激活数据进行了分析。此外,我们还评估了不同时期和不同机构干预措施的门户激活率。我们使用逻辑回归模型来确定与门户网站账户状态相关的重要人口统计学因素:在研究期间,我们的儿科机构为超过 100 万名患者提供了服务,其中 47.7% 的患者曾经激活过患者门户网站。单变量分析和最终逻辑回归模型显示,不同种族(几率比(置信区间):1.36 (1.34, 1.37))、语言偏好(1.39 (1.37, 1.40))和家庭收入中位数(1.00001 (1.00001, 1.00001))的患者在门户激活方面存在显著差异。讨论:讨论:总体而言,电子病历门户网站的激活率在西班牙裔、非英语使用者和家庭收入中位数较低社区的患者中较低:结论:在这些医疗服务不足的社区中,存在采取干预措施减少医疗差距的机会。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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