Adam T. Perzynski|Mary Joan Roach|Sarah Shick|Bill Callahan|Douglas D. Gunzler|Randall D. Cebul|David C. Kaelber|Anne M. Huml|J. Daryl Thornton|Douglas Einstadter
Patient portals and broadband internet inequality
Case Western Reserve University|MetroHealth|MetroHealth|Case Western Reserve University|Case Western Reserve University|Case Western Reserve University|MetroHealth|Case Western Reserve University|MetroHealth|Case Western Reserve University|MetroHealth|Case Western Reserve University|MetroHealth|Case Western Reserve University|MetroHealth|Case Western Reserve University|MetroHealth
abstract background patient portals shown potential increasing health care quality efficiency internet access factors influencing patient portal use could worsen health disparities methods observational study adults 1 visits outpatient clinics urban public health care system 2012 2015 used mixed effects logistic regression evaluate association broadband internet access 1 patient portal initiation whether patient logged least 1 time 2 messaging controlling demographic neighborhood characteristics results 243 248 adults 1 visits 20122015 70 835 291 initiated portal use portal initiation 341 whites 234 blacks 238 hispanics lower medicaid 265 medicare 234 uninsured patients 174 commercially insured patients 393 multivariate analysis initiation portal use odds ratio 124 per quintile 95 confidence interval ci 123124 p amplt 0001 sending messages providers 115 95ci 109114 p amplt 0001 associated neighborhood broadband internet access conclusions majority adults outpatient visits large urban health care system use patient portal initiation use lower racial ethnic minorities persons lower socioeconomic status without neighborhood broadband internet access results suggest emergence digital divide patient portal use given scale investment patient portals internetdependent health information technologies efforts urgently needed address growing inequality