On the effect of electronic patient portal on primary care utilization and appointment adherence

BMC Medical Informatics and Decision Making

Menggang Yu¹  Reynerio Sanchez²  Xiang Zhong²  Muxuan Liang³  Pamela R. Budd⁴  Marvin A. Dewar⁴  Julie L. Sprague⁴ 

[1] Department of Biostatistics & Medical Informatics, University of Wisconsin – Madison;Department of Industrial and Systems Engineering, University of Florida;Department of Statistics, University of Wisconsin – Madison;UF Health;

关键词: Patient portal;    Primary care utilization;    Appointment adherence;    Disease process;    Panel-DID;    Causal inference;   

DOI  :  10.1186/s12911-018-0669-8

来源: DOAJ

【 摘 要 】

Abstract Background The objective of this study was to investigate the impact of patient portal adoption on patients’ primary care utilization and appointment adherence. Methods We conducted a retrospective observational study using a panel difference-in-differences (DID) framework to investigate the use of primary care services by patients, adjusting for their disease burden and allowing for time-dependent portal effect. A large dataset with 46,544 patients of University of Florida (UF) Health during the study period July 2013 – June 2016 was used. The main outcome measures are disease burden adjusted rates of office visits arrived, no-show, and cancellation to primary care physicians (PCPs) per quarter between patient portal adopters (denoted as users) and non-users. Results At the time of adoption, the quarterly PCP office visit rate ratio (RR) of patient portal users to non-users was 1.33 (95% CI, 1.27–1.39; p < 0.001). The RRs were between 0.94 to 0.99 up to four quarters after portal adoption (p = 0.749, 0.100, 0.131, and 0.091, respectively), and were significantly less than one at the seventh (RR =0.82; 95% CI, 0.73–0.91; p < 0.001) and the eighth (RR = 0.80; 95% CI, 0.70–0.90; p < 0.001) quarters post adoption. The quarterly no-show rates of the users were significantly smaller (RRs were between 0.60 and 0.83) except for the seventh, eighth and tenth quarters post adoption. In these three quarters, the no-show rates were not significantly changed (p = 0.645, 0.295, and 0.436, respectively). Quarterly cancellation rates were not significantly affected by portal adoption (p > 0.05 for all cases). Conclusions Patient portal users’ disease burden adjusted PCP office visit rate was significantly reduced in one and a half year and thereafter post portal adoption. PCP appointment no-show rate was also significantly reduced and cancellation rate was not affected, implying improved care engagement of patients.

【 授权许可】

Unknown