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Currently submitted to: Journal of Medical Internet Research

Date Submitted: Sep 19, 2017
Open Peer Review Period: Sep 20, 2017 - Nov 15, 2017

NOTE: This is an unreviewed Preprint

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Personal Healthcare Management: Assessing the Relationship With Chronic Disease Prevalence

  • Ryan H Sandefer; 
  • Bonnie L Westra; 
  • Saif S Khairat; 
  • David S Pieczkiewicz; 
  • Stuart M Speedie

ABSTRACT

Background:

The use of personal healthcare management (PHM) is increasing rapidly within the U.S. due to implementation of health technology across the healthcare continuum and increased regulatory requirements for healthcare professionals and organizations promoting the use of PHM, particularly the use of messaging, online scheduling, and online requests for prescription renewals. Limited research has been conducted comparing PHM use across groups based upon chronic condition.

Objective:

The purpose of this research is to describe the overall utilization of PHM and compare individual characteristics associated with PHM in groups with no reported chronic conditions, with one chronic condition and with two or more such conditions.

Methods:

Datasets drawn from the National Health Interview Series were analyzed using multiple logistic regression to determine the level of PHM use in relation to demographic, socioeconomic, or health-related factors. Data from 47,814 individuals were analyzed using logistic regression.

Results:

Approximately 12 percent of respondents reported using PHM, but higher rates of use were reported by individuals with higher levels of education and income. The overall rate of PHM remained stable between 2009 and 2014, despite increased focus on the promotion of patient engagement initiatives. Demographic factors predictive of PHM use were younger, non-Hispanic, and people who lived in the western region of the United States were the most likely to use PHM. There were also differences in PHM use based upon socioeconomic factors. Respondents with college level education were over 2.5 times more likely to use PHM than respondents without college level education. Health related factors were also predictive of PHM use. Individuals with health insurance and a usual place for healthcare were more likely to use PHM than individuals with no health insurance and no usual place for healthcare. Individuals reporting a single chronic condition or multiple chronic conditions reported slightly higher levels of PHM use than individuals reporting no chronic condition. Individuals with no chronic conditions who did not experience barriers to accessing healthcare were more likely to use PHM than individuals with one or more chronic conditions.

Conclusions:

The findings of this study illustrated the disparities in PHM use based upon a number of chronic conditions, and that multiple factors influence the use of PHM, including economics and education. These findings provide evidence of the challenge associated with engaging patients through the use of electronic health information as the healthcare industry continues to evolve.