Socioeconomic deprivation, age and language are barriers to accessing personal health records: a cross-sectional study of a large hospital-based personal health record system

Rachel Chapman, Shamil Haroon, Nikita Simms-Williams, Neeraj Bhala, Foyzal Miah, Krishnarajah Nirantharakumar, James Ferguson

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To investigate barriers to accessing a hospital-based personal health record (PHR) system.

Design: Retrospective cross-sectional study.

Setting: This study was conducted in a large secondary and tertiary acute care trust in Birmingham, UK.

Participants: Data was collected from 28,637 patients who attended liver medicine, diabetes, renal medicine, or endocrinology specialist outpatient clinics from 1st June 2017 to 31st May 2018.

Primary and secondary outcome measures: The primary outcome measure was sign up to and activation of the PHR. The secondary outcomes were the use of the PHR, defined as the number of logons and frequency of access of specific PHR functions.

Results: 8,070 patients (28.2%) were signed-up to the PHR and 4,286 patients (53.1% of those signed-up) went on to activate their PHR account. Patients aged 75 years and older were significantly less likely to be signed-up (aOR 0.40, 95% confidence interval 0.36 to 0.44) or to activate (aOR 0.39, 0.32 to 0.47) their PHR than patients aged 35 to 54. Patients who did not need an interpreter were more likely to be signed-up (aOR 1.63, 1.33 to 1.99) and to activate (aOR 3.16, 1.96 to 5.09) their PHR. Patients living in the least deprived areas were more than twice as likely to be signed-up (aOR 2.31, 2.04 to 2.63), and were 3 times more likely to activate their PHR (aOR 2.99, 2.40 to 3.71), than those in the most deprived.

Conclusion: Socioeconomic deprivation, older age and non-English language were significant barriers to accessing a hospital-based PHR. Strategies are needed to account for these factors to ensure that PHRs do not widen health inequalities
Original languageEnglish
JournalBMJ open
Publication statusAccepted/In press - 20 Dec 2021

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