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Article Title

Race-Ethnic Differences in Kaiser Permanente Northern California Seniors’ Access and Preferences for Using the Web for Health Information and Health-Related Transactions, 2013

Publication Date

4-30-2015

Keywords

patient portal use, racial/ethnic disparities

Abstract

Background/Aims: Patients are being encouraged to use the Internet to obtain health information and interact with the health care system. However, surveys suggest lower use of the Internet by seniors, especially blacks, Latinos, and those aged 75+. We examined whether race-ethnic and age disparities exist in a Medicare-age population regarding readiness and preferences for using the Internet for health-related purposes.

Methods: In 2013 we surveyed an age-gender stratified random sample of non-Limited English Proficient white (W), black (B), Latino (L), Filipino (F) and Chinese (C) seniors aged 65–79 who were Kaiser Permanente Northern California members for 2+ years. The study sample was linked to 2013 kp.org utilization data (activated account, use of email, online lab views, online Rx refills). SAS Proc Surveymeans and Surveylogistic were used to analyze respondent data weighted to the study population. The final sample included 849 whites, 567 blacks, 653 Latinos, 219 Filipinos and 314 Chinese.

Results: Significant (P<0.05) race-ethnic differences were found in easy access to a computer (70.7% B, 63.0% L, 57.5% F vs. 85.3% W, 82.8% C), tablet (16.0% B, 12.6% L v. 27.1% W, 28.3% C) and smartphone (22.0% L, 19.6% F vs. 31.2% W, 32.8% B, 26.6% C). Blacks, Latinos and Filipinos were less likely to be able to send secure messages (50.2% B, 51.7% L, 52.0% F vs. 74.8% W, 73.5% C) and to prefer to use secure messaging (22.8% B, 25.5% L, 22.0% F vs. 51.4% W, 55.2% C), view lab results online (16.5% B, 17.7% L, 12.9% F vs. 35.3% W, 37.8% C), order Rx refills online (13.9% B, 16.5% L, 10.8% F vs. 34.0% W, 36.3% C), conduct video visits (12.3% B, 9.5% L, 10.6% F vs. 19.2% W), and view online videos (17.5% B, 15.2% L, 11.6% F vs. 26.7% W, 24.3% C). Whites were more likely to prefer to complete health risk appraisals online (34.7% W vs. 15.6% B, 16.8% L, 11.6% F, 24.3% C), with very low preference for in-clinic tablet or interactive voice response completion across all groups. Non-Internet users were more likely to indicate the shift to the Web has made it harder to communicate with doctors and obtain information.

Discussion: Race-ethnic and age-related differences in access to and preference for using the Internet for health-related purposes should be considered when planning and evaluating use of patient portals and providing health information to ensure that health care access is not decreased for seniors who cannot or prefer not to use the Internet.

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