Social disparities in internet patient portal use in diabetes: evidence that the digital divide extends beyond access
Open accessAbstract
The authors investigated use of the internet-based patient portal, kp.org, among a well-characterized population of adults with diabetes in Northern California. Among 14,102 diverse patients, 5671 (40%) requested a password for the patient portal. Of these, 4311 (76%) activated their accounts, and 3922 (69%), logged on to the patient portal one or more times; 2990 (53%) participants viewed laboratory results, 2132 (38%) requested medication refills, 2093 (37%) sent email messages, and 835 (15%) made medical appointments. After adjustment for age, gender, race/ethnicity, immigration status, educational attainment, and employment status, compared to non-Hispanic Caucasians, African-Americans and Latinos had higher odds of never logging on (OR 2.6 (2.3 to 2.9); OR 2.3 (1.9 to 2.6)), as did those without an educational degree (OR compared to college graduates, 2.3 (1.9 to 2.7)). Those most at risk for poor diabetes outcomes may fall further behind as health systems increasingly rely on the internet and limit current modes of access and communication.
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Without addressing this tension there is a risk that implementing telehealthcare may perversely widen health inequalities.
“Without addressing this tension there is the risk that implementing telehealthcare may perversely widen health inequalities [116].”
From The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview (2013) · cites this paper as [116]
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- Authors
- Sarkar, U., Karter, A. J., Liu, J. Y., Adler, N. E., Nguyen, R., Lopez, A., & Schillinger, D.
- Affiliations
- San Francisco General Hospital (US)
- Kaiser Permanente (US)
- University of California, San Francisco (US)
- Corresponding author
- Sarkar, U.
- Venue
- Journal of the American Medical Informatics Association
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-05-01
- Volume
- 18
- Issue
- 3
- Pages
- 318-321
- ISSN
- 1067-5027 (ISSN-L)
- 1527-974X
- PMC
- PMC3078675
- OpenAlex
- W2144168775
- Cited by
- 428
- References
- 17
- Citations by year
- 2026: 14 · 2025: 9 · 2024: 14 · 2023: 23 · 2022: 27 · 2021: 37 · 2020: 27 · 2019: 41 · 2018: 50 · 2017: 35 · 2016: 39 · 2015: 35 · 2014: 33 · 2013: 26 · 2012: 14
- FWCI
- 45.19
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Medical Informatics Association (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- Agency for Healthcare Research and Quality (K08HS017594, R18 HS01726101)
- U.S. Public Health Service (ULRR024131)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK080726, R01-DK65664, R01DK081796, R01DK065664)
- National Institute of Child Health and Human Development
- National Center for Research Resources (KL2RR024130)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD046113)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Social Sciences › Health › Health disparities and outcomes
- Keywords
- patient portals, diabetes mellitus, digital divide, social disparities, Kaiser Permanente, racial and ethnic disparities, educational attainment, online health communication
- MeSH terms
- Adult, Aged, Ambulatory Care Information Systems, California, Diabetes Mellitus, Educational Status, Ethnicity, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Socioeconomic Factors, Healthcare Disparities, Health Records, Personal
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