Department of Health & Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
Department of Health Information Management, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
Diabetes Technol Ther. 2019 Oct;21(10):546-556. doi: 10.1089/dia.2019.0074.
Patient portals empower patients by providing access to their health information and facilitating communication with care providers. This study aimed to examine the usage patterns of a patient portal offered as part of an electronic health record and to identify predictors of portal use among patients with type 2 diabetes (T2DM). A 2-year retrospective cohort study was performed using outpatient data from the health care system and its patient portal. Demographic and clinical data from 38,399 T2DM patients were analyzed. Descriptive statistics were used to summarize portal usage patterns. Binary logistic regression was employed to examine predictors and two-way interactions associated with portal use. Almost one-third of patients ( = 12,615; 32.9%, 95% confidence interval: [32.38%-33.32%]) had used the portal for a mean 2.5 ± 1.9 years before the study period. Portal use was higher on weekdays than on weekends ( < 0.001). An increase in portal use was observed in response to e-mail reminders. A nonlinear relationship between age and portal use was observed and depended on several other predictors (s < 0.05). Patients living in more rural areas with low income were at lower odds to use the portal ( = 0.021), and this finding also applied to nonwhites with low income ( < 0.001). More chronic conditions and a higher initial glycated hemoglobin value were associated with portal use ( = 0.014). The patient portal usage remained relatively stable over the 2-year period. A combination of factors was associated with an individual's patient portal use. Patient engagement in portal use can be facilitated through a proactive approach by health care providers.
患者门户通过提供对其健康信息的访问并促进与医疗服务提供者的沟通来增强患者的能力。本研究旨在检查作为电子健康记录一部分提供的患者门户的使用模式，并确定 2 型糖尿病 (T2DM) 患者使用门户的预测因素。 使用来自医疗保健系统及其患者门户的门诊数据进行了为期 2 年的回顾性队列研究。分析了 38399 名 T2DM 患者的人口统计学和临床数据。使用描述性统计来总结门户使用模式。采用二元逻辑回归检查与门户使用相关的预测因素和双向交互作用。 近三分之一的患者（= 12615；32.9%，95%置信区间：[32.38%-33.32%]）在研究期间之前已经使用门户了平均 2.5±1.9 年。与周末相比，平日使用门户的人数更多（ < 0.001）。观察到对电子邮件提醒的响应增加了门户的使用。观察到年龄与门户使用之间的非线性关系，并且取决于其他几个预测因素（s < 0.05）。居住在收入较低的农村地区的患者使用门户的可能性较低（= 0.021），这一发现也适用于收入较低的非白人（ < 0.001）。更多的慢性疾病和初始糖化血红蛋白值较高与门户使用相关（= 0.014）。 在 2 年期间，患者门户的使用相对稳定。一系列因素与个体使用患者门户相关。通过医疗服务提供者的积极方法可以促进患者参与门户使用。
