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The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study

BACKGROUND: During the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining...

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Autores principales: Sun, Enid Y, Alvarez, Carolina, Callahan, Leigh F, Sheikh, Saira Z
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439379/
https://www.ncbi.nlm.nih.gov/pubmed/36001872
http://dx.doi.org/10.2196/38802
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author Sun, Enid Y
Alvarez, Carolina
Callahan, Leigh F
Sheikh, Saira Z
author_facet Sun, Enid Y
Alvarez, Carolina
Callahan, Leigh F
Sheikh, Saira Z
author_sort Sun, Enid Y
collection PubMed
description BACKGROUND: During the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining inequities in health technology use among patients with RMDs. OBJECTIVE: Our goal was to identify characteristics associated with patient portal use before and after the COVID-19 pandemic in a convenience sample of patients with RMDs from a large academic medical center. METHODS: In this cross-sectional study, Epic electronic medical record data were queried to identify established patients of the University of North Carolina Hospitals adult rheumatology clinic between November 1, 2017, through November 30, 2019. Demographic and clinical data were collected to compare MyChart (Epic’s patient portal) users with nonusers before and after the COVID-19 pandemic. MyChart activation and use were modeled using logistic regression and adjusted odds ratios, and confidence intervals were estimated. RESULTS: We identified 5075 established patients with RMDs who met the inclusion criteria. Prior to the pandemic, we found that younger age (P<.001), suburban residence (P=.05), commercial/state insurance (P<.001), military insurance (P=.05), and median income >US $50,000 (P<.001) were associated with significantly higher odds of MyChart activation. Male sex (P<.001), being of Black or African American (P<.001) or “other” race (P<.001), Spanish as a primary language (P<.001), rural residence (P=.007), Medicaid insurance (P<.001), and median income of <US $25,000 (P=.01) were associated with lower odds of MyChart activation. Following COVID-19, younger age (P<.001), commercial insurance (P=.03), state insurance (P=.02), and median income of US $50,000-75,000 (P=.01) were associated with significantly higher odds of MyChart use. However, being of Black or African American (P<.001) or “other” race (P=.01), Spanish as a primary language (P=.002), male sex (P=.004), rural residence (P=.005), and having no insurance (P<.001) or Medicaid (P=.008) were associated with lower odds of MyChart use. CONCLUSIONS: Residence in a rural area, being of minority race/ethnicity, older age, male sex, lower median income, Medicaid, being uninsured, and non-English primary language are associated with lower odds of patient portal activation and use. Future health policy and clinical practice measures should focus on reducing barriers to health technology adoption among these groups.
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spelling pubmed-94393792022-09-03 The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study Sun, Enid Y Alvarez, Carolina Callahan, Leigh F Sheikh, Saira Z J Med Internet Res Original Paper BACKGROUND: During the COVID-19 pandemic, the shift to virtual care became essential for the continued care of patients. Individuals with rheumatic and musculoskeletal diseases (RMDs) especially require frequent provider visits and close monitoring. To date, there have been limited studies examining inequities in health technology use among patients with RMDs. OBJECTIVE: Our goal was to identify characteristics associated with patient portal use before and after the COVID-19 pandemic in a convenience sample of patients with RMDs from a large academic medical center. METHODS: In this cross-sectional study, Epic electronic medical record data were queried to identify established patients of the University of North Carolina Hospitals adult rheumatology clinic between November 1, 2017, through November 30, 2019. Demographic and clinical data were collected to compare MyChart (Epic’s patient portal) users with nonusers before and after the COVID-19 pandemic. MyChart activation and use were modeled using logistic regression and adjusted odds ratios, and confidence intervals were estimated. RESULTS: We identified 5075 established patients with RMDs who met the inclusion criteria. Prior to the pandemic, we found that younger age (P<.001), suburban residence (P=.05), commercial/state insurance (P<.001), military insurance (P=.05), and median income >US $50,000 (P<.001) were associated with significantly higher odds of MyChart activation. Male sex (P<.001), being of Black or African American (P<.001) or “other” race (P<.001), Spanish as a primary language (P<.001), rural residence (P=.007), Medicaid insurance (P<.001), and median income of <US $25,000 (P=.01) were associated with lower odds of MyChart activation. Following COVID-19, younger age (P<.001), commercial insurance (P=.03), state insurance (P=.02), and median income of US $50,000-75,000 (P=.01) were associated with significantly higher odds of MyChart use. However, being of Black or African American (P<.001) or “other” race (P=.01), Spanish as a primary language (P=.002), male sex (P=.004), rural residence (P=.005), and having no insurance (P<.001) or Medicaid (P=.008) were associated with lower odds of MyChart use. CONCLUSIONS: Residence in a rural area, being of minority race/ethnicity, older age, male sex, lower median income, Medicaid, being uninsured, and non-English primary language are associated with lower odds of patient portal activation and use. Future health policy and clinical practice measures should focus on reducing barriers to health technology adoption among these groups. JMIR Publications 2022-08-31 /pmc/articles/PMC9439379/ /pubmed/36001872 http://dx.doi.org/10.2196/38802 Text en ©Enid Y Sun, Carolina Alvarez, Leigh F Callahan, Saira Z Sheikh. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 31.08.2022. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
spellingShingle Original Paper
Sun, Enid Y
Alvarez, Carolina
Callahan, Leigh F
Sheikh, Saira Z
The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title_full The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title_fullStr The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title_full_unstemmed The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title_short The Disparities in Patient Portal Use Among Patients With Rheumatic and Musculoskeletal Diseases: Retrospective Cross-sectional Study
title_sort disparities in patient portal use among patients with rheumatic and musculoskeletal diseases: retrospective cross-sectional study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9439379/
https://www.ncbi.nlm.nih.gov/pubmed/36001872
http://dx.doi.org/10.2196/38802
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