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Differences in Access to and Use of Electronic Personal Health Information Between Rural and Urban Residents in the United States
Author(s) -
Greenberg Alexandra J.,
Haney Danielle,
Blake Kelly D.,
Moser Richard P.,
Hesse Bradford W.
Publication year - 2018
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/jrh.12228
Subject(s) - health information national trends survey , odds , health information technology , health care , medicine , patient portal , digital divide , rural area , family medicine , logistic regression , the internet , health information , nursing , environmental health , economic growth , world wide web , pathology , computer science , economics
Purpose The increase in use of health information technologies (HIT) presents new opportunities for patient engagement and self‐management. Patients in rural areas stand to benefit especially from increased access to health care tools and electronic communication with providers. We assessed the adoption of 4 HIT tools over time by rural or urban residency. Methods Analyses were conducted using data from 7 iterations of the National Cancer Institute's Health Information National Trends Survey (HINTS; 2003‐2014). Rural/urban residency was based on the USDA's 2003 Rural‐Urban Continuum Codes. Outcomes of interest included managing personal health information online; whether providers maintain electronic health records (EHRs); e‐mailing health care providers; and purchasing medicine online. Bivariate analyses and logistic regression were used to assess relationships between geography and outcomes, controlling for sociodemographic characteristics. Findings In total, 6,043 (17.6%, weighted) of the 33,749 respondents across the 7 administrations of HINTS lived in rural areas. Rural participants were less likely to report regular access to Internet (OR = 0.70, 95% CI = 0.61‐0.80). Rural respondents were neither more nor less likely to report that their health care providers maintained EHRs than were urban respondents; however, they had decreased odds of managing personal health information online (OR = 0.59, 95% CI = 0.40‐0.78) and e‐mailing health care providers (OR = 0.62, 95% CI = 0.49‐0.77). Conclusions The digital divide between rural and urban residents extends to HIT. Additional investigation is needed to determine whether the decreased use of HIT may be due to lack of Internet connectivity or awareness of these tools.