Patient Portal Underutilization: The Influence of Ethnicity and Low Income

Patient portals are online platforms that allow patients to access their health information, communicate with their providers, and manage their health care. Patient portals have the potential to improve patient engagement, satisfaction, and outcomes, especially for older adults who may have multiple chronic conditions and complex care needs. However, not all patients use patient portals, and there are significant disparities in patient portal utilization among different groups.

One of the factors that affects patient portal utilization is ethnicity. According to a study by Arcury et al. (2017), only 20.5% of ethnically diverse older adults who received care at clinics serving low income communities reported using patient portals. The study found that education, social support, and frequent Internet use were positively associated with patient portal utilization, while receiving care at a rural clinic was negatively associated with it. The authors suggested that cultural factors, such as language barriers, health literacy, trust in providers, and preferences for face-to-face communication, may also influence patient portal utilization among ethnic minorities.

Another factor that affects patient portal utilization is income. Low income patients may face barriers to accessing and using patient portals, such as lack of Internet access, computer skills, or privacy. Low income patients may also have competing priorities, such as financial stress, food insecurity, or housing instability, that limit their time and motivation to use patient portals. Moreover, low income patients may have less positive attitudes toward patient portals, such as perceived usefulness, ease of use, or satisfaction, than higher income patients.

Therefore, it is important to address the underutilization of patient portals among ethnically diverse and low income older adults, as they may benefit the most from the advantages of patient portals. Some possible strategies to increase patient portal utilization among these groups are:

– Providing education and training on how to use patient portals and their benefits
– Offering social support and peer mentoring from other patients or community members who use patient portals
– Enhancing the usability and accessibility of patient portals by incorporating user feedback, language options, and mobile compatibility
– Improving the trust and communication between providers and patients by addressing their concerns and preferences regarding patient portals
– Developing tailored interventions that consider the specific needs and challenges of different ethnic and income groups

By implementing these strategies, health care providers can promote patient portal utilization among ethnically diverse and low income older adults, and improve their health care quality and outcomes.

References:

Arcury TA, Quandt SA, Sandberg JC et al. Patient Portal Utilization Among Ethnically Diverse Low Income Older Adults: Observational Study. JMIR Med Inform 2017;5(4):e47. https://medinform.jmir.org/2017/4/e47/

Bullock K & Lott B. The Underutilization of Mental Health Services in an Ethnically and Racially Diverse Sample of Low-Income Women. Dissertation Abstracts International: Section B: The Sciences & Engineering 2002;63(4-B):2090. https://digitalcommons.unl.edu/dissertations/AAI3102569/

Neighbors HW. The Use of Formal Mental Health Services by Black Americans: A Review and Consideration of Research Needs. American Journal of Community Psychology 1984;12(6):685-702.

Shore MF. Cross-Cultural Issues in Mental Health Services Delivery: A Sociocultural Perspective. American Journal of Orthopsychiatry 1992;62(1):29-39.

Snowden LR & Cheung FK. Use of Inpatient Mental Health Services by Members of Ethnic Minority Groups. American Psychologist 1990;45(3):347-355.

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