Disparities in use of a personal health record in a managed care organization
UMass Chan AffiliationsDepartment of Quantitative Health Sciences
Document TypeJournal Article
*European Continental Ancestry Group
*Health Records, Personal
*Health Services Accessibility
Managed Care Programs
Patient Acceptance of Health Care
Proportional Hazards Models
Health Services Research
MetadataShow full item record
AbstractOBJECTIVE: Personal health records (PHRs) can increase patient access to health care information. However, use of PHRs may be unequal by race/ethnicity. DESIGN: The authors conducted a 2-year cohort study (2005-2007) assessing differences in rates of registration with KP.org, a component of the Kaiser Permanente electronic health record (EHR). MEASUREMENTS: At baseline, 1,777 25-59 year old Kaiser Permanente Georgia enrollees, who had not registered with KP.org, responded to a mixed mode (written or Internet) survey. Baseline, EHR, and KP.org data were linked. Time to KP.org registration by race from 10/1/05 (with censoring for disenrollment from Kaiser Permanente) was adjusted for baseline education, comorbidity, patient activation, and completion of the baseline survey online vs. by paper using Cox proportional hazards. RESULTS: Of 1,777, 34.7% (616) registered with KP.org between Oct 2005 and Nov 2007. Median time to registering a KP.org account was 409 days. Among African Americans, 30.1% registered, compared with 41.7% of whites (p < 0.01). In the hazards model, African Americans were again less likely to register than whites (hazard ratio [HR] = 0.652, 95% CI: 0.549-0.776) despite adjustment. Those with baseline Internet access were more likely to register (HR = 1.629, 95% CI: 1.294-2.050), and a significant educational gradient was also observed (more likely registration with higher educational levels). CONCLUSIONS: Differences in education, income, and Internet access did not account for the disparities in PHR registration by race. In the short-term, attempts to improve patient access to health care with PHRs may not ameliorate prevailing disparities between African Americans and whites.
SourceJ Am Med Inform Assoc. 2009 Sep-Oct;16(5):683-9. Epub 2009 Jun 30. Link to article on publisher's site
Permanent Link to this Itemhttp://hdl.handle.net/20.500.14038/47821
Related ResourcesLink to Article in PubMed
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