Role of Online Patient Portal Self-Scheduling and Self-Referral Pathways to Decrease Health Disparity for Screening...

Area of Science:

• Radiology and Imaging
• Health Services Research
• Health Equity

Background:

• Screening mammography is crucial for early breast cancer detection.
• Access to screening mammography can be limited by scheduling and referral barriers.
• Understanding sociodemographic factors influencing patient pathways is essential for improving access.

Purpose of the Study:

• To evaluate the utilization rates of self-scheduling and self-referral for screening mammography.
• To identify sociodemographic factors associated with the use of online self-scheduling and self-referral pathways.
• To assess the role of these pathways in addressing healthcare disparities in southern California.

Main Methods:

• Retrospective study of 22,306 patients undergoing screening mammography between February 2021 and September 2022.
• Analysis of sociodemographic data including age, race/ethnicity, language, insurance, and neighborhood disadvantage.
• Multivariable logistic regression models to determine associations with online self-scheduling and self-referral.

Main Results:

• 16.0% of patients used online self-scheduling, and 5.5% self-referred.
• Older age, Spanish-speaking, and Medicaid-insured patients were less likely to self-schedule.
• Hispanic and Asian patients, and those in disadvantaged neighborhoods were more likely to self-schedule.
• Older age and Spanish-speaking patients were less likely to self-refer.
• Black patients, Medicaid-insured patients, and those in disadvantaged neighborhoods were more likely to self-refer.

Conclusions:

• Online self-scheduling and self-referral pathways demonstrate sociodemographic variations in utilization.
• These digital tools appear to mitigate some existing barriers to screening mammography access.
• The findings suggest these pathways are a positive step towards reducing disparities in breast cancer screening.