Wang Hao, Kirby Ryan, Pierce Aimee, Barbaro Michael, Ho Amy F, Blalock Jake, Schrader Chet D
Department of Emergency Medicine, JPS Health Network, Fort Worth, TX 76104, USA.
TCU and UNTHSC School of Medicine, Fort Worth, TX 76107, USA.
J Clin Med Res. 2022 Oct;14(10):400-408. doi: 10.14740/jocmr4822. Epub 2022 Oct 28.
Patient portal (PP) use varies among different patient populations, specifically among those with diabetes mellitus (DM). In addition, it is still uncertain whether PP use could be linked to improved clinical outcomes. Therefore, the aim of this paper was to determine PP use status for patients, recognize factors promoting PP use, and further identify the association between PP use and clinical outcome among diabetic patients of different races and ethnicities.
This was a single-center cross-section study. Patients were divided into non-Hispanic white (NHW), non-Hispanic black (NHB), and Hispanic/Latino groups. PP use was compared among these three groups. Multivariate logistic regressions were used to determine factors associated with PP use, serum glycemic control, and emergency department (ED) hospitalizations.
A total of 77,977 patients were analyzed. The rate of PP use among patients of NHW (24%) was higher than those of NHB (19%) and Hispanic/Latinos (18%, P < 0.0001). The adjusted odds ratio (AOR) of insurance coverage associated with PP use was 2.12 (2.02 - 2.23, P < 0.0001), and having a primary care physician (PCP) associated with PP use was 3.89 (3.71 - 4.07, P < 0.0001). In terms of clinical outcomes, the AOR of PP use associated with serum glycemic control was 0.98 (0.90 - 1.05, P = 0.547) and ED hospitalization was 0.79 (0.73 - 0.86, P < 0.0001).
PP use disparity occurred among NHB and Hispanic/Latino patients in the ED. Having insurance coverage and PCPs seem to correlate with PP use. PP use did not seem to associate with serum glycemic control among DM patients present in the ED but could possibly reduce patient hospitalizations.
患者门户网站（PP）在不同患者群体中的使用情况各不相同，尤其是在糖尿病（DM）患者中。此外，PP的使用是否与改善临床结局相关仍不确定。因此，本文的目的是确定患者的PP使用状况，识别促进PP使用的因素，并进一步确定不同种族和族裔的糖尿病患者中PP使用与临床结局之间的关联。
这是一项单中心横断面研究。患者分为非西班牙裔白人（NHW）、非西班牙裔黑人（NHB）和西班牙裔/拉丁裔组。比较这三组的PP使用情况。采用多因素逻辑回归分析确定与PP使用、血糖控制和急诊科（ED）住院相关的因素。
共分析了77977例患者。NHW患者的PP使用率（24%）高于NHB患者（19%）和西班牙裔/拉丁裔患者（18%，P<0.0001）。与PP使用相关的保险覆盖调整比值比（AOR）为2.12（2.02-2.23，P<0.0001），有初级保健医生（PCP）与PP使用相关的AOR为3.89（3.71-4.07，P<0.0001）。在临床结局方面，与血糖控制相关的PP使用AOR为0.98（0.90-1.05，P=0.547），与ED住院相关的AOR为0.79（0.73-0.86，P<0.0001）。
急诊科中NHB和西班牙裔/拉丁裔患者在PP使用方面存在差异。拥有保险覆盖和PCP似乎与PP使用相关。在急诊科的糖尿病患者中，PP使用似乎与血糖控制无关，但可能会减少患者住院次数。
