On the effect of electronic patient portal on primary care utilization and appointment adherence
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 th...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | BMC Medical Informatics and Decision Making |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12911-018-0669-8 |
| _version_ | 1818357508414111744 |
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| author | Xiang Zhong Muxuan Liang Reynerio Sanchez Menggang Yu Pamela R. Budd Julie L. Sprague Marvin A. Dewar |
| author_facet | Xiang Zhong Muxuan Liang Reynerio Sanchez Menggang Yu Pamela R. Budd Julie L. Sprague Marvin A. Dewar |
| author_sort | Xiang Zhong |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-13T20:14:13Z |
| format | Article |
| id | doaj.art-cd01f0740d814b648f0383c8cb38baa1 |
| institution | Directory Open Access Journal |
| issn | 1472-6947 |
| language | English |
| last_indexed | 2024-12-13T20:14:13Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Informatics and Decision Making |
| spelling | doaj.art-cd01f0740d814b648f0383c8cb38baa12022-12-21T23:32:51ZengBMCBMC Medical Informatics and Decision Making1472-69472018-10-0118111210.1186/s12911-018-0669-8On the effect of electronic patient portal on primary care utilization and appointment adherenceXiang Zhong0Muxuan Liang1Reynerio Sanchez2Menggang Yu3Pamela R. Budd4Julie L. Sprague5Marvin A. Dewar6Department of Industrial and Systems Engineering, University of FloridaDepartment of Statistics, University of Wisconsin – MadisonDepartment of Industrial and Systems Engineering, University of FloridaDepartment of Biostatistics & Medical Informatics, University of Wisconsin – MadisonUF HealthUF HealthUF HealthAbstract 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.http://link.springer.com/article/10.1186/s12911-018-0669-8Patient portalPrimary care utilizationAppointment adherenceDisease processPanel-DIDCausal inference |
| spellingShingle | Xiang Zhong Muxuan Liang Reynerio Sanchez Menggang Yu Pamela R. Budd Julie L. Sprague Marvin A. Dewar On the effect of electronic patient portal on primary care utilization and appointment adherence BMC Medical Informatics and Decision Making Patient portal Primary care utilization Appointment adherence Disease process Panel-DID Causal inference |
| title | On the effect of electronic patient portal on primary care utilization and appointment adherence |
| title_full | On the effect of electronic patient portal on primary care utilization and appointment adherence |
| title_fullStr | On the effect of electronic patient portal on primary care utilization and appointment adherence |
| title_full_unstemmed | On the effect of electronic patient portal on primary care utilization and appointment adherence |
| title_short | On the effect of electronic patient portal on primary care utilization and appointment adherence |
| title_sort | on the effect of electronic patient portal on primary care utilization and appointment adherence |
| topic | Patient portal Primary care utilization Appointment adherence Disease process Panel-DID Causal inference |
| url | http://link.springer.com/article/10.1186/s12911-018-0669-8 |
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