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ArtikelDisparities in Use of a Personal Health Record in a Managed Care Organization  
Oleh: Roblin, Douglas W. ; Houston, Thomas K. ; Allison, Jeroan J. ; Joski, Peter J. ; Becker, Edmund R.
Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: JAMIA ( Journal Of the American Medical Informatics Association ) vol. 16 no. 5 (Sep. 2009), page 683-689.
Topik: Personal health records (PHRs)
Ketersediaan
  • Perpustakaan FK
    • Nomor Panggil: J43.K.2009.02
    • Non-tandon: 1 (dapat dipinjam: 0)
    • Tandon: tidak ada
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Isi artikelObjective: 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.
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