College of Health Solutions, Arizona State University, Phoenix, Arizona, USA.
Department of Health Systems and Population Health Sciences, Humana Integrated Health System Sciences Institute, University of Houston College of Medicine, Houston, Texas, USA.
Popul Health Manag. 2021 Dec;24(6):675-680. doi: 10.1089/pop.2021.0055. Epub 2021 May 14.
Health information technology (HIT) can enhance optimal health care access and utilization among individuals living with chronic diseases. This study aimed to provide population-level information on racial/ethnic disparities in HIT use and associated trends among those living with chronic diseases. The study sample consisted of adult respondents (≥18 years) of the 2011-2018 National Health Interview Survey living with at least 1 chronic condition. Binomial regression was used to analyze the association between race/ethnicity, year, and 4 measures of HIT use for patient-provider interaction. Regression parameter estimates were used to predict the trends in probability of the outcome variables across race/ethnicity. About 73% of the study sample were non-Hispanic Whites, 15% were non-Hispanic Blacks, and 13% were Hispanics. Compared to non-Hispanic Whites, there were decreased adjusted odds of any HIT use among non-Hispanic Blacks (OR = 0.72; 95% CI = 0.67, 0.76) and Hispanics (OR = 0.78; 95% CI = 0.72, 0.84). The likelihood of any HIT use increased with increasing year (OR: 1.16; 95% CI = 1.15, 1.18). Trends in racial/ethnic disparities were wider for email communication with provider and online prescription refill compared to online scheduling of appointment. The COVID-19 pandemic has led to accelerated adoption or expansion of HIT for patient care. Limited HIT use among non-Hispanic Blacks and Hispanics could worsen the disproportionate chronic disease burden, suboptimal clinical outcomes, and preventable health care costs experienced by this subpopulation. In conclusion, there is a need for intentional and strategic population-level interventions to increase HIT adoption and use among non-Hispanic Blacks and Hispanics living with chronic diseases.
健康信息技术 (HIT) 可以增强慢性病患者获得和利用最佳医疗保健的机会。本研究旨在提供人群层面的信息，说明慢性病患者中 HIT 使用的种族/民族差异及其相关趋势。研究样本由 2011-2018 年全国健康访谈调查中至少患有 1 种慢性病的成年受访者（≥18 岁）组成。使用二项式回归分析种族/民族、年份和 4 项用于医患互动的 HIT 使用措施之间的关联。回归参数估计用于预测跨种族/民族的结果变量概率趋势。研究样本中约 73%是非西班牙裔白人，15%是非西班牙裔黑人，13%是西班牙裔。与非西班牙裔白人相比，非西班牙裔黑人（OR=0.72；95%CI=0.67，0.76）和西班牙裔（OR=0.78；95%CI=0.72，0.84）使用任何 HIT 的调整后优势比降低。随着年份的增加（OR：1.16；95%CI=1.15，1.18），任何 HIT 使用的可能性都会增加。与在线预约安排相比，通过电子邮件与提供者进行沟通和在线处方续配的种族/民族差异趋势更加明显。COVID-19 大流行导致 HIT 在患者护理中的采用或扩展加速。非西班牙裔黑人和西班牙裔人群中 HIT 的使用有限，可能会使这一人群不成比例地加重慢性病负担、临床结局不佳和可预防的医疗保健费用。总之，需要在人群层面进行有针对性和战略性的干预，以增加非西班牙裔黑人和西班牙裔慢性病患者对 HIT 的采用和使用。
