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美国电子健康领域的医患沟通:兴趣、不平等现象及预测因素

eHealth patient-provider communication in the United States: interest, inequalities, and predictors.

作者信息

Spooner Kiara K, Salemi Jason L, Salihu Hamisu M, Zoorob Roger J

机构信息

Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas.

Baylor College of Medicine, Houston, Texas.

出版信息

J Am Med Inform Assoc. 2017 Apr 1;24(e1):e18-e27. doi: 10.1093/jamia/ocw087.

Abstract

OBJECTIVE

Health-related Internet use and eHealth technologies, including online patient-provider communication (PPC), are continually being integrated into health care environments. This study aimed to describe sociodemographic and health- and Internet-related correlates that influence adult patients' interest in and electronic exchange of medical information with health care providers in the United States.

METHODS

Nationally representative cross-sectional data from the 2014 Health Information National Trends Survey ( N  = 3677) were analyzed. Descriptive statistics and multivariable regression analyses were performed to examine associations between patient-level characteristics and online PPC behavior and interests.

RESULTS

Most respondents were Internet users (82.8%), and 61.5% of information seekers designated the Internet as their first source for health information. Younger respondents (<50 years), Hispanics, those from higher-income households, and those perceiving access to personal health information as important were more likely to be interested in online PPC. Despite varying levels of patient interest, 68.5% had no online PPC in the last year. However, Internet users (odds ratio, OR = 2.87, 95% CI, 1.35-6.08), college graduates (OR = 2.92, 95% CI, 1.42-5.99), and those with frequent provider visits (OR = 1.94, 95% CI, 1.02-3.71) had a higher likelihood of online PPC via email or fax, while Hispanics and those from higher-income households were 2-3 times more likely to communicate via text messaging or phone/mobile apps.

CONCLUSION

Patients' interest in and display of online PPC-related behaviors vary by age, race/ethnicity, education, income, Internet access/behaviors, and information type. These findings can inform efforts aimed at improving the use and adoption of eHealth technologies, which may contribute to a reduction in communication inequalities and health care disparities.

摘要

目的

与健康相关的互联网使用和电子健康技术,包括在线患者与医疗服务提供者沟通(PPC),正不断融入医疗环境。本研究旨在描述影响美国成年患者对与医疗服务提供者进行医疗信息电子交换的兴趣的社会人口统计学、健康及互联网相关因素。

方法

分析了来自2014年健康信息国家趋势调查的具有全国代表性的横断面数据(N = 3677)。进行描述性统计和多变量回归分析,以检验患者层面特征与在线PPC行为及兴趣之间的关联。

结果

大多数受访者是互联网用户(82.8%),61.5%的信息寻求者将互联网指定为其健康信息的首要来源。较年轻的受访者(<50岁)、西班牙裔、高收入家庭的受访者以及认为获取个人健康信息很重要的受访者更有可能对在线PPC感兴趣。尽管患者兴趣程度不同,但68.5%的人在过去一年中没有进行过在线PPC。然而,互联网用户(优势比,OR = 2.87,95%置信区间,1.35 - 6.08)、大学毕业生(OR = 2.92,95%置信区间,1.42 - 5.99)以及经常就诊的患者(OR = 1.94,95%置信区间,1.02 - 3.71)通过电子邮件或传真进行在线PPC的可能性更高,而西班牙裔和高收入家庭的受访者通过短信或电话/移动应用进行沟通的可能性高出2至3倍。

结论

患者对在线PPC相关行为的兴趣和表现因年龄、种族/民族、教育程度、收入、互联网接入/行为以及信息类型而异。这些发现可为旨在改善电子健康技术的使用和采用的努力提供信息,这可能有助于减少沟通不平等和医疗保健差距。

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