Henry Shayna L, Shen Ernest, Ahuja Andre, Gould Michael K, Kanter Michael H
Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena, California.
Kaiser Permanente Southern California Department of Research and Evaluation, Pasadena, California.
Am J Prev Med. 2016 Jul;51(1):71-7. doi: 10.1016/j.amepre.2015.11.014. Epub 2016 Jan 27.
Patient-facing online tools for managing preventive and chronic care can be a resource-effective way to increase patient agency in health promotion. Recently, Kaiser Permanente Southern California added the Online Personal Action Plan (oPAP) to the member web portal to better enable members to access information about prevention, health promotion, and care gaps. This study described Kaiser Permanente Southern California members who use oPAP, as well as how members use oPAP to close five different care gaps: hemoglobin A1c testing, pneumonia vaccination, and three cancer screenings.
Care gap closure rates between oPAP users and members not registered on the online patient portal between December 2014 and March 2015 were compared. Data were analyzed in 2015. A total of 838,638 cases (48.9% women; mean age, 49.5 years; 40.4% oPAP users) were examined.
Adjusting for demographics, BMI, smoking status, health and insurance status, and number of open care gaps, oPAP access was associated with a somewhat greater likelihood of care gap closure within 90 days for select care gap types, particularly hemoglobin A1c testing and breast, cervical, and colorectal cancer screening among eligible members. The effect of oPAP access on care gap closure differed by certain ethnic minority groups.
Although healthcare organizations have developed approaches to managing and closing preventive care gaps, these efforts are resource intensive. Users of oPAP are more likely than non-registered members to close gaps, especially cancer screening tests. The oPAP appears to be an effective tool at improving patient engagement in preventive health care.
面向患者的在线工具可用于管理预防保健和慢性病护理，这是一种资源高效的方式，能够增强患者在健康促进方面的自主性。最近，南加州凯撒医疗集团在会员门户网站上添加了在线个人行动计划（oPAP），以便会员更好地获取有关预防、健康促进和护理差距的信息。本研究描述了使用oPAP的南加州凯撒医疗集团会员，以及会员如何使用oPAP来填补五个不同的护理差距：糖化血红蛋白检测、肺炎疫苗接种和三项癌症筛查。
比较了2014年12月至2015年3月期间oPAP用户与未注册在线患者门户网站的会员之间的护理差距填补率。数据于2015年进行分析。共检查了838,638个病例（48.9%为女性；平均年龄49.5岁；40.4%为oPAP用户）。
在调整了人口统计学、体重指数、吸烟状况、健康和保险状况以及未填补的护理差距数量后，对于特定的护理差距类型，尤其是符合条件的会员中的糖化血红蛋白检测以及乳腺癌、宫颈癌和结直肠癌筛查，使用oPAP在90天内填补护理差距的可能性略高。oPAP对护理差距填补的影响因某些少数族裔群体而异。
尽管医疗保健机构已经开发出管理和填补预防保健差距的方法，但这些努力资源消耗大。使用oPAP的用户比未注册会员更有可能填补差距，尤其是癌症筛查测试。oPAP似乎是提高患者参与预防保健的有效工具。
