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Personal health record use for children and health care utilization: propensity score-matched cohort analysis
Yi Yvonne Zhou1, Wendy M Leith2, Hui Li3
1Northwest Permanente, Innovation and Care Transformation, Portland, Oregon, USA yvonne.y.zhou@kp.org.
Insights
Caregiver use of personal health records (PHR) was linked to more pediatric outpatient visits and telephone calls. Higher PHR engagement correlated with increased healthcare utilization among children.
Area of Science:
- Health Informatics
- Pediatric Healthcare
- Health Services Research
Background:
- Personal health records (PHR) offer a platform for patient engagement in healthcare.
- Understanding the impact of caregiver PHR use on pediatric healthcare utilization is crucial for optimizing resource allocation.
- Previous research has explored PHR adoption, but specific associations with pediatric utilization patterns require further investigation.
Purpose of the Study:
- To investigate the relationship between caregiver personal health record (PHR) utilization and healthcare service use in pediatric patients.
- To determine if and how PHR engagement influences outpatient visits, telephone encounters, and emergency department visits for children.
Main Methods:
- A retrospective observational cohort study was conducted involving 2286 pediatric members (aged 6 months to 2.5 years).
- Propensity score matching was employed to compare healthcare utilization between PHR-registered and non-registered children.
- Statistical analyses, including t-tests, chi-square tests, and ANOVA, were used to assess associations and utilization across PHR use quartiles.
Main Results:
- Children whose caregivers used PHRs showed a statistically significant increase in outpatient clinic visits (21%) and telephone encounters (26%) compared to non-users.
- Healthcare utilization differences were more pronounced for non-primary care providers than for primary care providers.
- A positive association was observed between the highest quartile of PHR use and increased outpatient visits and telephone encounters; no significant differences were found in the lower three quartiles.
Conclusions:
- Caregiver engagement with personal health records is associated with a significant rise in outpatient clinic visits and telephone encounters for pediatric patients.
- The findings suggest that PHR use may facilitate greater interaction with the healthcare system for children.
- Further research could explore the mechanisms driving this association and its implications for pediatric care management.
Objectives:
To examine the association between caregiver personal health record (PHR) use and health care utilization by pediatric patients.
Design, Setting, And Participants:
We conducted a retrospective observational cohort study of 2286 pediatric members aged six months to 2.5 years of Kaiser Permanente Hawaii and Northwest Regions in 2007-2011, using propensity score matching methods and t and chi-square tests to examine associations between PHR use and health care utilization. We used ANOVA to examine utilization across quartiles of PHR use.
Main Outcome Measures:
Outpatient clinic visits, telephone encounters, and emergency department visits.
Results:
PHR-registered children, compared with propensity score-matched nonregistered children, had 21% (95% CI, 14-28; P < .0001) more outpatient clinic visits and 26% (95% CI, 16-37; P < .0001) more telephone encounters. Utilization differences were more pronounced with nonprimary care providers than with primary care providers. Outpatient clinic visits and telephone encounters increased among the quartile with the highest PHR use; no utilization differences occurred in the 3 lowest-use quartiles.
Conclusions:
PHR use by caregivers was associated with statistically significant increases in outpatient clinic visits and telephone encounters among pediatric patients.
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