Indianapolis VA HSR&D Center for Health Information and Communication, Roudebush VA, Indianapolis, Indiana.
Division of General Internal Medicine & Geriatrics, Indiana University School of Medicine, Indianapolis, Indiana.
J Rural Health. 2019 Mar;35(2):144-154. doi: 10.1111/jrh.12358. Epub 2019 Mar 4.
This statewide survey sought to understand the adoption level of new health information and medical technologies, and whether these patterns differed between urban and rural populations.
A random sample of 7,979 people aged 18-75 years, stratified by rural status and race, who lived in 1 of 34 Indiana counties with high cancer mortality rates and were seen at least once in the past year in a statewide health system were surveyed.
Completed surveys were returned by 970 participants. Rural patients were less likely than urban to use electronic health record messaging systems (28.3% vs 34.5%, P = .045) or any communication technology (43.0% vs 50.8%, P = .017). Rural patients were less likely to look for personal health information for someone else's medical record (11.0% vs 16.3%, P = .022), look-up test results (29.5% vs 38.3%, P = .005), or use any form of electronic medical record (EMR) access (57.5% vs 67.1%, P = .003). Rural differences in any use of communication technology or EMRs were no longer significant in adjusted models, while education and income were significantly associated. There was a trend in the higher use of low-dose computed tomography (CT) scan among rural patients (19.1% vs 14.4%, P = .057). No significant difference was present between rural and urban patients in the use of the human papilloma virus test (27.1% vs 26.6%, P = .880).
Differences in health information technology use between rural and urban populations may be moderated by social determinants. Lower adoption of new health information technologies (HITs) than medical technologies among rural, compared to urban, individuals may be due to lower levels of evidence supporting HITs.
本全州范围的调查旨在了解新的健康信息和医疗技术的采用水平，以及这些模式在城乡人群之间是否存在差异。
对居住在印第安纳州 34 个高癌症死亡率县中的 1 个县、年龄在 18-75 岁之间、按农村状况和种族分层、在过去一年中至少在全州卫生系统就诊过一次的 7979 人进行了随机抽样调查。
完成的调查由 970 名参与者返回。农村患者使用电子健康记录信息系统的可能性低于城市患者（28.3%对 34.5%，P =.045）或任何通信技术（43.0%对 50.8%，P =.017）。农村患者为他人医疗记录查找个人健康信息的可能性较小（11.0%对 16.3%，P =.022）、查询检查结果的可能性较小（29.5%对 38.3%，P =.005）或使用任何形式的电子病历（EMR）访问（57.5%对 67.1%，P =.003）。在调整后的模型中，农村地区在任何通信技术或 EMR 使用率方面的差异不再显著，而教育程度和收入则与差异显著相关。农村患者更倾向于使用低剂量计算机断层扫描（CT）扫描（19.1%对 14.4%，P =.057）。农村患者和城市患者在使用人乳头瘤病毒检测方面没有显著差异（27.1%对 26.6%，P =.880）。
城乡人群在健康信息技术使用方面的差异可能受到社会决定因素的影响。与城市个体相比，农村个体对新的健康信息技术（HITs）的采用率低于医疗技术，这可能是由于 HITs 的证据水平较低所致。
