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Diabetes Quality of Care and Outpatient Utilization Associated With Electronic Patient-Provider Messaging: A Cross-Sectional Analysis

By Lynne T. Harris, Sebastien J. Haneuse, Diane P. Martin and James D. Ralston


OBJECTIVE — To test the hypothesis that electronic patient-provider messaging is associated with high care quality for diabetes and lower outpatient utilization. RESEARCH DESIGN AND METHODS — We conducted a cross-sectional analysis of electronic patient-provider messaging over a 15-month period between 1 January 2004 and 31 March 2005. The study was set at Group Health Cooperative—a consumer-governed, nonprofit health care system that operates in Washington and Idaho. Participants included all patients aged �18 years with a diagnosis of diabetes. In addition to usual care, all patients had the option to use electronic messaging to communicate with their care providers. The primary outcome measures were diabetes-related quality-of-care indicators (A1C, blood pressure, and LDL cholesterol) and outpatient visits (primary care, specialty care, and emergency). RESULTS — Nineteen percent of patients with diabetes used electronic messaging to communicate with their care providers during the study period (n � 2,924) (overall study cohort: 15,427 subjects). In multivariate models, frequent use of electronic messaging was associated with A1C �7 % (relative risk [RR] 1.36 [95 % CI 1.16–1.58]). Contrary to our hypothesis, frequent use of electronic messaging was also associated with a higher rate of outpatient visit

Year: 2013
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