JMIR Publications

ABSTRACT

Background:

Studies have previously shown that rural cancer patients are diagnosed at later stages of disease, and often have poorer clinical outcomes as compared to their urban counterparts. Few studies have explored whether there is a difference in cancer patients’ current utilization of HIT tools by residential location.

Objective:

In this present study, we sought to 1) determine the overall use of ePHI tools among cancer patients in urban and rural regions, and 2) assess the rate of email communication between cancer patients in urban and rural regions with their health care provider.

Methods:

Data from 7 cycles of the Health Information National Trends Survey (HINTS, 2003-2017) were merged and analyzed to examine whether differences exist in managing personal health information (PHI) online and e-mailing healthcare providers among rural and urban cancer patients. Geographic location was categorized using Rural-Urban Continuum Codes (RUCCs). Bivariate analyses and multivariable logistic regression were used to determine whether associations existed between rural/urban residency and use of HIT among cancer patients.

Results:

Of the 4163 cancer patients/survivors who responded across the 7 cycles of HINTS, 797 (26.9%) resided in rural areas. No difference was found between rural and urban cancer patients in having managed PHI electronically in the past 12 months (OR = 0.78, 95% CI = 0.43-1.40). Rural cancer patients were significantly less likely to e-mail health care providers than their urban counterparts (OR = 0.52, 95% CI = 0.32-0.84).

Conclusions:

The digital divide between rural and urban cancer residents does not extend to general electronic PHI management; however, electronic communication with providers is significantly less among rural cancer patients than urban cancer patients. Further research is needed to determine whether such disparities extend to other HIT tools that might benefit rural cancer patients as well as other chronic conditions.