Health Information at Your Fingertips: Social Determinants of Health associated with Patient Portal Use

Purpose: Offering patients electronic access to their diagnostic tests and imaging results can improve long-term health outcomes. However, patient portals are not universally accessible, and few studies have evaluated the barriers to accessing portal health information. This study aimed to explore patient characteristics associated with portal access.

Methods/Materials: Data from the 2022 National Cancer Institute's Health Information National Trends Survey (HINTS 6) was used. Adult patients (age ≥ 18) who responded to the survey question about patient portal access were included. A multivariate logistic regression analysis was performed using SPSS software to determine patient characteristics associated with portal access.

Results: 5958 patients were included (mean age = 55.6; 60.4% female; 70.6% White, 18.2% Black; 17.7% Hispanic). 61.3% of all respondents reported accessing portals an average of 3-5 times over the last 12 months, and 43.8% of all respondents used multiple portals. 90.5% of those with portal access reported using portals to view test results and 19.5% to send information to a third party such as a healthcare provider. Patients less likely to use portals were those older than 65 (OR: 0.36; 95% CI: 0.29-0.45), male (OR: 0.72; 95% CI: 0.61-0.84), Black (vs. White) (OR: 0.78; 95% CI: 0.64-0.96), and Hispanic (OR: 0.79; 95% CI: 0.64-0.99). Patients with income ≥ $50,000 (OR: 1.41; 95% CI: 1.19-1.67), college education (OR: 2.03; 95% CI: 1.72-2.38), higher health literacy (OR: 1.45; 95% CI: 1.15-1.81), health insurance (OR: 2.24; 95% CI: 1.68-2.99), at least one medical condition (OR:1.20; 95% CI: 1.01-1.43) and were offered access by healthcare providers (OR: 17.61; 95% CI: 14.60-21.24) were much more likely to use portals.

Conclusions: A majority of respondents did use patient portals, however, certain demographics face greater difficulty accessing them. Several factors were identified as targets for interventions to promote equitable and widespread access to patient portals. Future studies should focus on developing approaches that healthcare providers can employ to increase patient portal access for diagnostic test and imaging information.