Anthony Denise, Campos-Castillo Celeste
Professor, Health Management & Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Associate Professor, Department of Sociology, University of Wisconsin-Milwaukee.
R I Med J (2013). 2020 Feb 3;103(1):32-34.
Online portals that provide patients with secure access to their medical records and provider communication can improve health care. Yet new technologies can also exacerbate existing health disparities. We analyzed information about 2,325 insured respondents to the nationally representative 2017 Health Information National Trends Survey to examine characteristics of portal nonusers and reasons for nonuse. Sixty-three percent reported not using a portal during the prior year. In multivariable analysis, we found that nonusers were more likely to be male, be on Medicaid, lack a regular provider, and have less than a college education, compared to users. Similar disparities existed in who reported being offered access to a portal, with nonwhites also less likely to report being offered access. Reasons for nonuse included privacy concerns and the desire to speak directly to providers, both of which indicate the important role of the doctor-patient relationship.
为患者提供安全访问其医疗记录及与医疗服务提供者沟通渠道的在线平台能够改善医疗保健状况。然而，新技术也可能加剧现有的健康差距。我们分析了具有全国代表性的2017年健康信息国家趋势调查中2325名有保险受访者的信息，以研究未使用平台者的特征及未使用原因。63%的受访者表示上一年未使用过平台。在多变量分析中，我们发现与使用者相比，未使用者更可能为男性、参加医疗补助计划、没有固定的医疗服务提供者且受教育程度低于大学水平。在报告获得平台访问权限的人群中也存在类似的差距，非白人报告获得访问权限的可能性也较小。未使用的原因包括对隐私的担忧以及希望直接与医疗服务提供者交流，这两者都表明了医患关系的重要作用。
