Patient-initiated Electronic Messages and Quality of Care for Patients With Diabetes and Hypertension in a Large Fee-for-Service Medical Group
Results From a Natural Experiment
Bibliographic Data
| ID | 9103779 |
|---|---|
| Authors | Sean R McClellan (0000-0003-3355-343X, Qualis Health), Laura Panattoni (0000-0002-5081-5043), Albert S Chan, Albert Chan (0000-0002-4972-5569), Ming Tai-Seale |
| Year | 2016 |
| Volume | 54 |
| Issue | 3 |
| Pages | 287-295 |
| Publication date | 2016-03-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000483 |
| PMID | 26759978 |
| OpenAlex | W2462796393 |
| Language | EN |
| Citations received | 2 |
| References cited | 32 |
BACKGROUND: Few studies have examined the association between patient-initiated electronic messaging (e-messaging) and clinical outcomes in fee-for-service settings. OBJECTIVE: To estimate the association between patient-initiated e-messages and quality of care among patients with diabetes and hypertension. DESIGN: Longitudinal observational study from 2009 to 2013. In March 2011, the medical group eliminated a $60/year patient user fee for e-messaging and established a provider payment of $3-5 per patient-initiated e-message. Quality of care for patients initiating e-messages was compared before and after March 2011, relative to nonmessaging patients. Propensity score weighting accounted for differences between e-messaging and nonmessaging patients in generalized estimating equations. SETTING: Large multispecialty practice in California compensating providers' fee-for-service. SUBJECTS: Patients with diabetes (N=4232) or hypertension (N=15,463) who had activated their online portal but not e-messaged before e-messaging became free. MEASURES: Quality of care included HEDIS-based process measures for hemoglobin (Hb) A1c, blood pressure, low-density lipoprotein (LDL), nephropathy, and retinopathy tests, and outcome measures for HbA1c, blood pressure, and LDL. E-messaging was measured as counts of patient-initiated e-message threads sent to providers. Patients were categorized into quartiles by e-messaging frequency. RESULTS: The probability of annually completing indicated tests increased by 1%-7% for e-messaging patients, depending on the outcome and e-messaging frequency. E-messaging was associated with small improvements in HbA1c and LDL for some patients with diabetes. CONCLUSION: Patient-initiated e-messaging may increase the likelihood of completing recommended tests, but may not be sufficient to improve clinical outcomes for most patients with diabetes or hypertension without additional interventions
Diabetes mellitus · Family medicine · Health care · Medical emergency · Patient portal · Short Message Service · Computer Science · Diabetes Management and Education · Emergency Medicine · Internal Medicine · Medicine · Mobile Health and mHealth Applications · Telemedicine and Telehealth Implementation
To GEE or Not to GEE
Variable Selection for Propensity Score Models
Evaluating the Quality of Medical Care
A tutorial on propensity score estimation for multiple treatments using generalized boosted models
Balance diagnostics for comparing the distribution of baseline covariates between treatment groups in propensity‐score matched samples
Estimation of Regression Coefficients When Some Regressors are not Always Observed
The central role of the propensity score in observational studies for causal effects
Matching Methods for Causal Inference
Constructing a Control Group Using Multivariate Matched Sampling Methods That Incorporate the Propensity Score
The Multiple Propensity Score as Control for Bias in the Comparison of More Than Two Treatment Arms
Recent Developments in the Econometrics of Program Evaluation
| Citations per year | 0.2 |
|---|---|
| Citation span | 2016 - 2018 (3) |
| Highly cited | No |