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Patient Portal Barriers and Group Differences: Cross-Sectional National Survey Study.
Journal of Medical Internet Research ( IF 7.4 ) Pub Date : 2020-09-17 , DOI: 10.2196/18870
Kea Turner 1 , Alecia Clary 2 , Young-Rock Hong 3 , Amir Alishahi Tabriz 4 , Christopher M Shea 5
Affiliation  

Background: Past studies examining barriers to patient portal adoption have been conducted with a small number of patients and health care settings, limiting generalizability. Objective: This study had the following two objectives: (1) to assess the prevalence of barriers to patient portal adoption among nonadopters and (2) to examine the association between nonadopter characteristics and reported barriers in a nationally representative sample. Methods: Data from this study were obtained from the 2019 Health Information National Trends Survey. We calculated descriptive statistics to determine the most prevalent barriers and conducted multiple variable logistic regression analysis to examine which characteristics were associated with the reported barriers. Results: The sample included 4815 individuals. Among these, 2828 individuals (58.73%) had not adopted a patient portal. Among the nonadopters (n=2828), the most prevalent barriers were patient preference for in-person communication (1810/2828, 64.00%), no perceived need for the patient portal (1385/2828, 48.97%), and lack of comfort and experience with computers (735/2828, 25.99%). Less commonly, individuals reported having no patient portal (650/2828, 22.98%), no internet access (650/2828, 22.98%), privacy concerns (594/2828, 21.00%), difficulty logging on (537/2828, 18.99%), and multiple patient portals (255/2828, 9.02%) as barriers. Men had significantly lower odds of indicating a preference for speaking directly to a provider compared with women (odds ratio [OR] 0.75, 95% CI 0.60-0.94; P=.01). Older age (OR 1.01, 95% CI 1.00-1.02; P<.001), having a chronic condition (OR 1.83, 95% CI 1.44-2.33; P<.001), and having an income lower than US $20,000 (OR 1.61, 95% CI 1.11-2.34; P=.01) were positively associated with indicating a preference for speaking directly to a provider. Hispanic individuals had significantly higher odds of indicating that they had no need for a patient portal (OR 1.59, 95% CI 1.24-2.05; P<.001) compared with non-Hispanic individuals. Older individuals (OR 1.05, 95% CI 1.04-1.06; P<.001), individuals with less than a high school diploma (OR 3.15, 95% CI 1.79-5.53; P<.001), and individuals with a household income of less than US $20,000 (OR 2.78, 95% CI 1.88-4.11; P<.001) had significantly higher odds of indicating that they were uncomfortable with a computer. Conclusions: The most common barriers to patient portal adoption are preference for in-person communication, not having a need for the patient portal, and feeling uncomfortable with computers, which are barriers that are modifiable and can be intervened upon. Patient characteristics can help predict which patients are most likely to experience certain barriers to patient portal adoption. Further research is needed to tailor implementation approaches based on patients’ needs and preferences.

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.


中文翻译:

患者门禁障碍和群体差异:跨国家的全国调查研究。

背景:过去的研究已经对少数患者和医疗机构进行了研究,以了解阻碍患者采用门户的障碍,从而限制了推广性。目的:本研究具有以下两个目标:(1)评估非采用者中患者采用门户的障碍的患病率;(2)检查全国代表性样本中非采用者特征与报告的障碍之间的关联。方法:这项研究的数据来自2019年健康信息国家趋势调查。我们计算了描述性统计数据以确定最普遍的障碍,并进行了多变量逻辑回归分析以检查哪些特征与报告的障碍相关。结果:样本包括4815个人。其中2828人(58。73%)未采用患者门户。在非采用者中(n = 2828),最普遍的障碍是患者对面对面沟通的偏爱(1810/2828,64.00%),对患者门脉的无感知需求(1385/2828,48.97%)和缺乏舒适感和使用计算机的经验(735 / 2828,25.99%)。较少见的个人报告称没有患者门户(650/2828,22.98%),没有互联网访问(650/2828,22.98%),隐私问题(594/2828,21.00%),登录困难(537/2828,18.99) %)和多个患者门户(255 / 2828,9.02%)作为障碍。与女性相比,男性表示倾向于直接与提供者说话的几率要低得多(优势比[OR] 0.75,95%CI 0.60-0.94; P = .01)。患有慢性病(OR 1.83,95%CI 1.44-2.33; P <.001)的年龄较大(OR 1.01,95%CI 1.00-1.02; P <.001),且收入低于20,000美元(或1.61,95%CI 1.11-2.34; P = .01)与表明倾向于直接与提供者通话表示正相关。与非西班牙裔个体相比,西班牙裔个体具有更高的可能性,表明他们不需要患者门户(OR 1.59,95%CI 1.24-2.05; P <.001)。老年人(OR 1.05,95%CI 1.04-1.06; P <.001),未获得高中文凭的人(OR 3.15,95%CI 1.79-5.53; P <.001)和家庭收入的个人少于$ 20,000美元(OR 2.78,95%CI 1.88-4.11; P <.001)的可能性更高,表明他们对电脑不满意。结论:采用患者门户网站的最常见障碍是人们首选面对面交流,而不需要患者门户网站,对计算机感到不舒服,因为计算机是可以修改并可以干预的障碍。患者特征可以帮助预测哪些患者最有可能在采用患者门户方面遇到某些障碍。需要进一步研究以根据患者的需求和喜好定制实施方法。

这仅仅是抽象的。阅读JMIR网站上的全文。JMIR是互联网时代电子健康和医疗保健领域领先的开放获取期刊。
更新日期:2020-09-18
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