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dc.contributor.authorRoblin, Douglas W.
dc.contributor.authorHouston, Thomas K.
dc.contributor.authorAllison, Jeroan J.
dc.contributor.authorJoski, Peter J.
dc.contributor.authorBecker, Edmund R.
dc.date2022-08-11T08:10:44.000
dc.date.accessioned2022-08-23T17:18:17Z
dc.date.available2022-08-23T17:18:17Z
dc.date.issued2009-09-02
dc.date.submitted2011-01-27
dc.identifier.citationJ Am Med Inform Assoc. 2009 Sep-Oct;16(5):683-9. Epub 2009 Jun 30. <a href="http://dx.doi.org/10.1197/jamia.M3169">Link to article on publisher's site</a>
dc.identifier.issn1067-5027 (Linking)
dc.identifier.doi10.1197/jamia.M3169
dc.identifier.pmid19567790
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47821
dc.description.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.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19567790&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1197/jamia.M3169
dc.subjectAdult
dc.subject*African Americans
dc.subjectCohort Studies
dc.subjectEducation
dc.subject*European Continental Ancestry Group
dc.subjectFemale
dc.subjectGeorgia
dc.subject*Health Records, Personal
dc.subject*Health Services Accessibility
dc.subjectHumans
dc.subjectMale
dc.subjectManaged Care Programs
dc.subjectMiddle Aged
dc.subjectMultivariate Analysis
dc.subjectPatient Acceptance of Health Care
dc.subjectProportional Hazards Models
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleDisparities in use of a personal health record in a managed care organization
dc.typeJournal Article
dc.source.journaltitleJournal of the American Medical Informatics Association : JAMIA
dc.source.volume16
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/936
dc.identifier.contextkey1749243
html.description.abstract<p>OBJECTIVE: Personal health records (PHRs) can increase patient access to health care information. However, use of PHRs may be unequal by race/ethnicity.</p> <p>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).</p> <p>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.</p> <p>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).</p> <p>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.</p>
dc.identifier.submissionpathqhs_pp/936
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages683-9


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