Department of Emergency Medicine, Integrative Emergency Services, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
Department of Family Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104, USA.
Am J Emerg Med. 2023 Apr;66:118-123. doi: 10.1016/j.ajem.2023.01.029. Epub 2023 Jan 31.
Patient portal (PP) use has rapidly increased in recent years. However, the PP use status among houseless patients is largely unknown. We aim to determine 1) the PP use status among Emergency Department (ED) patients experiencing houselessness, and 2) whether PP use is linked to the increase in patient clinic visits.
This is a single-center retrospective observational study. From March 1, 2019, to February 28, 2021, houseless patients who presented at ED were included. Their PP use status, including passive PP use (log-on only PP) and effective PP use (use PP of functions) was compared between houseless and non-houseless patients. The number of clinic visits was also compared between these two groups. Lastly, a multivariate logistic regression was analyzed to determine the association between houseless status and PP use.
We included a total of 236,684 patients, 13% of whom (30,956) were houseless at time of their encounter. Fewer houseless patients had effective PP use in comparison to non-houseless patients (7.3% versus 11.6%, p < 0.001). In addition, a higher number of clinic visits were found among houseless patients who had effective PP use than those without (18 versus 3, p < 0.001). The adjusted odds ratio of houseless status associated with PP use was 0.48 (95% CI 0.46-0.49, p < 0.001).
Houselessness is a potential risk factor preventing patient portal use. In addition, using patient portals could potentially increase clinic visits among the houseless patient population.
近年来，患者门户（PP）的使用迅速增加。然而，无家可归患者的 PP 使用情况在很大程度上尚不清楚。我们旨在确定 1）无家可归的急诊科（ED）患者的 PP 使用情况，以及 2）PP 使用是否与患者就诊次数的增加有关。
这是一项单中心回顾性观察性研究。从 2019 年 3 月 1 日至 2021 年 2 月 28 日，我们纳入了在 ED 就诊的无家可归患者。比较了无家可归患者和非无家可归患者的 PP 使用情况，包括被动 PP 使用（仅登录 PP）和有效 PP 使用（使用 PP 的功能）。还比较了这两组患者的就诊次数。最后，进行了多变量逻辑回归分析，以确定无家可归状态与 PP 使用之间的关联。
我们共纳入了 236684 名患者，其中 13%（30956 名）在就诊时无家可归。与非无家可归患者相比，有效使用 PP 的无家可归患者比例较低（7.3%对 11.6%，p<0.001）。此外，与无有效 PP 使用的患者相比，有效使用 PP 的无家可归患者就诊次数更多（18 次对 3 次，p<0.001）。与 PP 使用相关的无家可归状态的调整优势比为 0.48（95%置信区间 0.46-0.49，p<0.001）。
无家可归是阻碍患者门户使用的一个潜在危险因素。此外，使用患者门户可能会增加无家可归患者人群的就诊次数。
