A Multi-Level Analysis of Individual and Neighborhood Factors Associated with Patient Portal Use among Adult Emergency Department Patients with Multimorbidity

Hao Wang (), Chan Shen, Michael Barbaro, Amy F. Ho, Mona Pathak, Cita Dunn and Usha Sambamoorthi
Additional contact information
Hao Wang: Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
Chan Shen: Department of Surgery, Penn State Cancer Institute, Hershey, PA 17033, USA
Michael Barbaro: Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
Amy F. Ho: Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, 1500 S. Main St., Fort Worth, TX 76104, USA
Mona Pathak: Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
Cita Dunn: TCU and UNTHSC School of Medicine, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA
Usha Sambamoorthi: Texas Center for Health Disparities, Department of Pharmacotherapy, College of Pharmacy, University of North Texas Health Science Center, Fort Worth, TX 76107, USA

IJERPH, 2023, vol. 20, issue 2, 1-14

Abstract: Background: Patient portals tethered to electronic health records (EHR) have become vital to patient engagement and better disease management, specifically among adults with multimorbidity. We determined individual and neighborhood factors associated with patient portal use (MyChart) among adult patients with multimorbidity seen in an Emergency Department (ED). Methods: This study adopted a cross-sectional study design and used a linked database of EHR from a single ED site to patients’ neighborhood characteristics (i.e., zip code level) from the American Community Survey. The study population included all adults (age > 18 years), with at least one visit to an ED and multimorbidity between 1 January 2019 to 31 December 2020 (N = 40,544). Patient and neighborhood characteristics were compared among patients with and without MyChart use. Random-intercept multi-level logistic regressions were used to analyze the associations of patient and neighborhood factors with MyChart use. Results: Only 19% (N = 7757) of adults with multimorbidity used the patient portal. In the fully adjusted multi-level model, at the patient level, having a primary care physician (AOR = 5.55, 95% CI 5.07–6.07, p < 0.001) and health insurance coverage (AOR = 2.41, 95% CI 2.23–2.61, p < 0.001) were associated with MyChart use. At the neighborhood level, 4.73% of the variation in MyChart use was due to differences in neighborhood factors. However, significant heterogeneity existed in patient portal use when neighborhood characteristics were included in the model. Conclusions: Among ED patients with multimorbidity, one in five adults used patient portals. Patient-level factors, such as having primary care physicians and insurance, may promote patient portal use.

Keywords: patient portal; multimorbidity; multi-level models; emergency department; adults (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/20/2/1231/pdf (application/pdf)
https://www.mdpi.com/1660-4601/20/2/1231/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:20:y:2023:i:2:p:1231-:d:1030804

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().