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电子健康记录患者门户的获取与使用差异。

Disparities in Access and Utilization of Electronic Health Record Patient Portals.

作者信息

Shah Atman, Fiala Mark A

机构信息

Saint Louis University School of Medicine, St. Louis, MO, USA.

Division of Oncology, Washington University School of Medicine, St. Louis, MO, USA.

出版信息

J Gen Intern Med. 2025 Jan 22. doi: 10.1007/s11606-025-09359-z.

DOI:10.1007/s11606-025-09359-z
PMID:39843664
Abstract

OBJECTIVE

The aim of this study was to assess changes in the accessibility and utilization of electronic health record patient portals in recent years, focusing on whether these changes occurred equitably across different racial, ethnic, and socioeconomic groups.

MATERIALS AND METHODS

The study utilized nationally representative samples from the 2019 and 2022 Health Information National Trends Surveys. A difference-in-differences design was used to determine if increases in access and utilization occurred equally for all segments of the population.

RESULTS

From 2019 to 2022, the proportion of people reporting being offered access to a patient portal by a healthcare provider increased from 72.3 to 83.7% and the proportion who reported using a portal increased from 68.0 to 81.9%. African American or Black respondents had similar increases in access and utilization of portals as non-Hispanic Whites, but disparities remained. Hispanics, who were more likely to utilize patient portals in 2019, saw a smaller increase in utilization than non-Hispanic Whites. Increasing disparities in access and/or utilization of patient portals was observed among people with lower household incomes, people without college degrees, and people over the age of 65.

CONCLUSION

An increased reliance on digital healthcare technologies has increased patient portal accessibility and utilization; however, increases have not been equitable across all demographic groups with many disparities persisting or worsening.

摘要

目的

本研究旨在评估近年来电子健康记录患者门户网站的可及性和使用情况的变化,重点关注这些变化在不同种族、族裔和社会经济群体中是否公平发生。

材料与方法

该研究使用了2019年和2022年《健康信息国家趋势调查》中的全国代表性样本。采用差异中的差异设计来确定所有人群在获取和使用方面的增长是否相同。

结果

从2019年到2022年,报告从医疗服务提供者处获得患者门户网站访问权限的人群比例从72.3%增至83.7%,报告使用门户网站的人群比例从68.0%增至81.9%。非裔美国人或黑人受访者在门户网站的获取和使用方面的增长与非西班牙裔白人相似,但差距仍然存在。西班牙裔在2019年更有可能使用患者门户网站,但与非西班牙裔白人相比,其使用量的增长较小。在家庭收入较低、没有大学学位的人群以及65岁以上的人群中,患者门户网站的获取和/或使用方面的差距在不断扩大。

结论

对数字医疗技术的更多依赖提高了患者门户网站的可及性和使用情况;然而,并非所有人口群体的增长都是公平的,许多差距仍然存在或正在恶化。

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本文引用的文献

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Progress and Persistent Disparities in Patient Access to Electronic Health Information.患者获取电子健康信息的进展和持续差距。
JAMA Health Forum. 2023 Nov 3;4(11):e233883. doi: 10.1001/jamahealthforum.2023.3883.
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J Am Med Inform Assoc. 2023 Jan 18;30(2):308-317. doi: 10.1093/jamia/ocac227.
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Telehealth and COVID-19 Pandemic: An Overview of the Telehealth Use, Advantages, Challenges, and Opportunities during COVID-19 Pandemic.远程医疗与新冠疫情:新冠疫情期间远程医疗的使用、优势、挑战及机遇概述
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Why are Patient Portals Important in the Age of COVID-19? Reflecting on Patient and Team Experiences From a Toronto Hospital Network.为何患者门户网站在新冠疫情时代至关重要?反思多伦多医院网络中的患者及团队体验。
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The Impact of Digital Patient Portals on Health Outcomes, System Efficiency, and Patient Attitudes: Updated Systematic Literature Review.数字患者门户对健康结果、系统效率和患者态度的影响:更新的系统文献综述。
J Med Internet Res. 2021 Sep 8;23(9):e26189. doi: 10.2196/26189.
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Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic - United States, January-March 2020.COVID-19 大流行期间远程医疗使用趋势 - 美国,2020 年 1 月至 3 月。
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