Mahmood Asos, Mosalpuria Kavita, Wyant David K, Bhuyan Soumitra S
a Division of Health Systems Management and Policy, School of Public Health , The University of Memphis , Memphis, TN , USA.
b College of Public Health , University of Nebraska Medical Center , Omaha , NE , USA.
Hosp Top. 2019 Jan;97(1):1-10. doi: 10.1080/00185868.2018.1551102. Epub 2018 Dec 31.
A regular care provider is an important measure of access to health services, but little is known about the association between having a regular provider and patients' access to services associated with electronic health records (EHR). Furthermore, the composition of the additional electronic services made available to patients is not well studied.
We analyzed the most recent data from the Health Information National Trends Survey (HINTS5-Cycle1, 2017, n = 3,285). We estimated a weighted multivariable logistic regression model to assess the association between having a regular provider (65.3%) and access to EHR (29%). Control variables were selected based on Andersen's Behavioral Model.
In the adjusted model, participants with a regular provider had significantly greater access to an EHR (aOR 2.91, p < .001) compared to participants without a regular provider. Participants were more likely to have access to an EHR if they were females (aOR 1.56, p < .01), had a tablet computer (aOR 1.55, p < .05), smartphone (aOR 2.27, p < .01), a former smoker (aOR 1.67, p < .05) or had two or more chronic medical conditions (aOR 1.79, p < .01).
Individuals who have a regular provider are roughly three times as likely to have access to services linked to an EHR. Access to an EHR enhances both potential and realized access to many healthcare services.
The availability of a regular care provider impacts the "digital divide." The expansion of electronic health services intensifies the importance of a regular care provider.
有一位固定的医疗服务提供者是衡量获得医疗服务机会的一项重要指标,但对于有固定提供者与患者获取与电子健康记录(EHR)相关服务之间的关联,我们了解甚少。此外,向患者提供的额外电子服务的构成也未得到充分研究。
我们分析了来自《健康信息国家趋势调查》(HINTS5 - 第1周期,2017年,n = 3285)的最新数据。我们估计了一个加权多变量逻辑回归模型,以评估有固定提供者(65.3%)与获取电子健康记录(29%)之间的关联。根据安德森行为模型选择了控制变量。
在调整后的模型中,与没有固定提供者的参与者相比,有固定提供者的参与者获取电子健康记录的机会显著更高(调整后的比值比为2.91,p <.001)。如果参与者为女性(调整后的比值比为1.56,p <.01)、拥有平板电脑(调整后的比值比为1.55,p <.05)、智能手机(调整后的比值比为2.27,p <.01)、曾经吸烟(调整后的比值比为1.67,p <.05)或患有两种或更多慢性疾病(调整后的比值比为1.79,p <.01),则他们更有可能获取电子健康记录。
有固定提供者的个体获取与电子健康记录相关服务的可能性大约是其他人的三倍。获取电子健康记录可增强获取许多医疗服务的潜在机会和实际机会。
有固定医疗服务提供者会影响“数字鸿沟”。电子健康服务的扩展强化了固定医疗服务提供者的重要性。