Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
Center for Connected Care, Mayo Clinic, Rochester, Minnesota, USA.
J Rural Health. 2022 Sep;38(4):908-915. doi: 10.1111/jrh.12657. Epub 2022 Mar 8.
Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest.
We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-rural locality and incorporated patients' sociodemographic factors into the analysis.
The urban-rural ratio of portal users, message senders, and COVID-19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban-rural ratio (1.69) of PGMs on COVID-19 was higher than that (1.43) of general PGMs. The urban-rural ratios of messaging were 1.72-1.85 for COVID-19-related care and 1.43-1.66 for other health care issues on COVID-19. Compared with urban patients, rural patients sent fewer messages for COVID-19 diagnosis and treatment but more messages for other reasons related to COVID-19-related health care (eg, isolation and anxiety). The frequent senders of COVID-19-related messages among rural patients were 40+ years old, women, married, and White.
In this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID-19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.
农村人口受 COVID-19 大流行的影响不成比例。我们描述了 COVID-19 患者门户信息利用方面的城乡差异，以及在中西部地区早期使用该门户的患者。
我们收集了 2020 年 2 月至 8 月期间中西部地区梅奥诊所患者的 100 多万条门户信息。我们根据城乡位置分析了患者生成的 COVID-19 信息，并将患者的社会人口统计学因素纳入分析。
门户用户、消息发送者和 COVID-19 消息发送者的城乡比例分别为 1.18、1.31 和 1.79，表明城市患者的使用比例更高。COVID-19 患者生成的消息（PGM）的城乡比例（1.69）高于一般 PGM（1.43）。与城市患者相比，农村患者在 COVID-19 相关护理方面的消息发送比例为 1.72-1.85，在其他 COVID-19 相关医疗保健问题方面的消息发送比例为 1.43-1.66。农村患者发送的 COVID-19 诊断和治疗相关消息较少，但与 COVID-19 相关医疗保健相关的其他原因（如隔离和焦虑）的消息较多。农村患者中 COVID-19 相关消息的高频发送者为 40 岁以上、女性、已婚和白人。
在这个中西部医疗系统中，农村患者在大流行期间不太可能使用患者在线服务，他们使用该服务的原因与城市患者不同。研究结果表明，有机会增加农村患者参与患者门户的公平性（特别是少数族裔）以应对 COVID-19。公共卫生干预策略可以针对农村患者在大流行期间寻求医疗保健的原因，例如社会隔离和焦虑。
