Department of Family and Community Medicine, University of Texas Health Science Center, San Antonio, TX 78207, USA.
J Am Board Fam Med. 2012 Sep-Oct;25(5):625-34. doi: 10.3122/jabfm.2012.05.120043.
The digital revolution is changing the manner in which patients communicate with their health care providers, yet many patients still lack access to communication technology. We conducted this study to evaluate access to, use of, and preferences for using communication technology among a predominantly low-income patient population. We determined whether access, use, and preferences were associated with type of health insurance, sex, age, and ethnicity.
In 2011, medical student researchers administered questionnaires to patients of randomly selected physicians within 9 primary care clinics in the Residency Research Network of Texas. Surveys addressed access to and use of cell phones and home computers and preferences for communicating with health care providers.
In this sample of 533 patients (77% response rate), 448 (84%) owned a cell phone and 325 (62%) owned computers. Only 48% reported conducting Internet searches, sending and receiving E-mails, and looking up health information on the Internet. Older individuals, those in government sponsored insurance programs, and individuals from racial/ethnic minority groups had the lowest levels of technology adoption. In addition, more than 60% of patients preferred not to send and receive health information over the Internet, by instant messaging, or by text messaging.
Many patients in this sample did not seek health information electronically nor did they want to communicate electronically with their physicians. This finding raises concerns about the vision of the patient-centered medical home to enhance the doctor-patient relationship through communication technology. Our patients represent some of the more vulnerable populations in the United States and, as such, deserve attention from health care policymakers who are promoting widespread use of communication technology.
数字革命正在改变患者与医疗服务提供者沟通的方式,但许多患者仍然无法获得通讯技术。我们开展这项研究,旨在评估主要为低收入患者群体获取、使用和偏好使用通讯技术的情况。我们确定了获取、使用和偏好是否与医疗保险类型、性别、年龄和种族有关。
2011 年,医学生研究人员在德克萨斯州住院医师研究网络的 9 个初级保健诊所中,对随机选择的医生的患者进行问卷调查。调查涵盖了对手机和家庭电脑的获取和使用情况,以及与医疗服务提供者交流的偏好。
在这项 533 名患者(77%的回应率)的样本中,448 名(84%)拥有手机,325 名(62%)拥有电脑。仅有 48%的患者报告会进行互联网搜索、发送和接收电子邮件,以及在互联网上查询健康信息。年龄较大的人、参加政府赞助保险计划的人以及来自种族/少数民族群体的人采用技术的程度最低。此外,超过 60%的患者更倾向于不通过互联网、即时消息或短信来发送和接收健康信息。
该样本中的许多患者不会通过电子方式获取健康信息,也不想通过电子方式与他们的医生进行沟通。这一发现令人担忧,因为以患者为中心的医疗模式旨在通过通讯技术增强医患关系,但我们的患者代表了美国一些更脆弱的人群,因此,医疗保健政策制定者应该关注他们,这些政策制定者正在推动通讯技术的广泛应用。