JMIR Publications

ABSTRACT

Background:

Effective patient-provider communication is the core of high-quality patient-centered care. Communication through electronic platforms such as web, patient portal, or mobile phone (referring as e-communication) has become increasingly important as it extends traditional in-person communication with less limitation of timing and locations, and has the potential to facilitate more effective interactions between patients and providers. However, little is known about the current status of patients’ use of e-communication with healthcare providers and whether the use is related to better perceived quality of care at the population level.

Objective:

This study was designed to explore the prevalence of, and factors associated with e-communication and effect of e-communication on patient perceived quality of care, using the nationally representative sample of the 2019 Health Information National Trends Survey 5 (HINTS 5)-Cycle 3.

Methods:

Data from 5,438 survey responders aged 18 years+ (mean=49.04 years, range=18-98) were included in the analysis. All variables were measured using self-report surveys. Logistic and linear regression analyses were used to explore responders’ profile characteristics related to use of e-communication and that use related quality of care. Descriptive sub-analyses for e-communication according to age groups were also performed. All analyses considered the complex design using the jackknife replication method.

Results:

The overall prevalence of the use of e-communication was 60%, with the lowest prevalence in older adults aged 65 years or above (17%), significantly lower than adults younger than 45 years old (41%) and adults aged between 45-65 years (42%) (p<.001). American adults who had some college (OR=3.14, 95% CI 1.52–6.48, p=.003) or college graduate+ (OR=4.14, 95% CI 2.04–8.39, p<.001), household income at or greater than $50,000 (OR=1.75, 95% CI 1.25–2.46, p=.002), or a regular provider (OR=1.93, 95% CI 1.43–2.61, p<.001) were more likely to use e-communication. In contrast, those who reside in rural area (OR=0.59, 95% CI 0.39–0.89, p=.014) were less likely to use e-communication. After controlling for demographic (e.g., age, gender, education, income, and comorbidity) and relationship factors (e.g., regular provider, communication quality, and trust a doctor), the use of e-communication was statistically significantly associated with better quality of care (β=0.13, 95% CI 0.01-0.25, p=.039).

Conclusions:

Our findings on factors associated with e-communication and the positive association between e-communication and quality of care suggest that policy-level attention is needed to engage the socially disadvantaged (i.e., those with lower levels of education and income, without a regular provider, and living rural area) to maximize the use of e-communication and to support better quality of care among American adults. Clinical Trial: NOT APPLICABLE