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Patient Portal Use and Risk of Readmissions in Decompensated Cirrhosis: Retrospective Study
Jeremy Louissaint1, Jeffrey Gibbs2, Abhishek Shenoy2,3
1Division of Digestive and Liver Diseases, University of Texas Southwestern, Dallas, TX, United States.
JMIR Formative Research
|December 19, 2023
Summary
Moderate active use of patient portals is linked to fewer hospital readmissions for patients with decompensated cirrhosis. Passive portal use, however, showed no association with readmission risk.
Area of Science:
- Hepatology and Gastroenterology
- Digital Health and Health Informatics
- Patient Outcomes Research
Background:
- Patient portals are key electronic health record tools facilitating patient-provider communication.
- While common, the effect of patient portal utilization on clinical outcomes in cirrhosis remains understudied.
- This research investigates the link between patient portal engagement and hospital readmissions in this population.
Purpose of the Study:
- To evaluate the association between distinct patient portal usage patterns and readmission rates in patients with decompensated cirrhosis.
- To differentiate the impact of active versus passive patient portal use on clinical outcomes.
Main Methods:
- A cohort of 131 patients with decompensated cirrhosis hospitalized between May 2018 and May 2019 was analyzed.
- Patient portal usage (messaging, test result review) was categorized as active or passive and stratified by frequency (no, moderate, frequent) over a 6-month pre-admission period.
- Primary outcomes included 90-day and overall readmissions, adjusted for key clinical factors like MELD-Na score and ascites.
Main Results:
- 63.4% of patients were enrolled in the patient portal, with no significant demographic or clinical differences observed.
- Passive portal use (reading messages/results) was high (97.6%), but not significantly associated with readmissions.
- Moderate active use (sending messages) was linked to significantly lower 90-day readmissions (OR 0.77) and overall readmissions (SHR 0.42).
Conclusions:
- High passive patient portal engagement in cirrhosis patients does not correlate with reduced readmission risk.
- Moderately active patient portal use demonstrates a protective effect against hospital readmissions in decompensated cirrhosis.
- Further research is warranted to identify specific behaviors and confounders influencing readmission risk reduction through patient portal use.
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