Observational studyPloS one2019
Patients with complex chronic conditions: Health care use and clinical events associated with access to a patient portal.
Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review.Journal of medical Internet research · 2020Pooled it
- Multilevel Intervention to Increase Patient Portal Use in Adults With Type 2 Diabetes Who Access Health Care at Community Health Centers: Single Arm, Pre-Post Pilot Study.JMIR formative research · 2025Trial
- Understanding Patient-Reported Offenses in Electronic Health Records: Cross-Sectional Mixed Methods Survey.Journal of medical Internet research · 2026Article
- Analysis of the Behavioral Performance and Social Support of Patients in Online Health Communities From User Profile Perspectives: Comparative Study.Journal of medical Internet research · 2025Article
- National trends in oncology specialists' EHR inbox work, 2019-2022.Journal of the National Cancer Institute · 2025Article
- Uptake and user characteristics of MyChart within a Canadian community hospital with a diverse patient population: A comparative study.PLOS digital health · 2025Article
- Outpatient Portal Use and Blood Pressure Management during Pregnancy.AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science · 2025Article
- Protocol for a randomized controlled trial of patient-portal-based screening for substance use among people with HIV.Frontiers in public health · 2025Article
- Associations between patient portal use and electronic health record (EHR) data timeliness in type 2 diabetes mellitus care.Journal of diabetes and metabolic disorders · 2024Article
- Patient portal registration and healthcare utilisation in general practices in England: a longitudinal cohort study.BJGP open · 2024Article
- Personal Health Record implementation in rural primary care: A descriptive exploratory study using RE-AIM framework.PLOS digital health · 2024Article
- Patient Perspectives on Portal-Based Anxiety and Depression Screening in HIV Care: A Qualitative Study Using the Consolidated Framework for Implementation Research.International journal of environmental research and public health · 2024Article
- Disparities in Patient Portal Engagement Among Patients With Hypertension Treated in Primary Care.JAMA network open · 2024Article
- Association of Remote Patient Monitoring with Mortality and Healthcare Utilization in Hypertensive Patients: a Medicare Claims-Based Study.Journal of general internal medicine · 2024Article
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- A Multi-Level Analysis of Individual and Neighborhood Factors Associated with Patient Portal Use among Adult Emergency Department Patients with Multimorbidity.International journal of environmental research and public health · 2023Article
- Continuity of care in primary healthcare settings among patients with chronic diseases in Saudi Arabia.SAGE open medicine · 2023Article
- Mobilizing registry data for quality improvement: A convergent mixed-methods analysis and application to spinal cord injury.Frontiers in rehabilitation sciences · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundFor patients with diabetes, many with multiple complex chronic conditions, using a patient portal can support self-management and coordination of health care services, and may impact the frequency of in-person health care visits.
objectiveTo examine the impact of portal access on the number of outpatient visits, emergency visits, and preventable hospitalizations.
designObservational study comparing patients' visit rates with and without portal access, using marginal structural modeling with inverse probability weighting estimates to account for potential bias due to confounding and attrition.
settingLarge integrated delivery system which implemented a patient portal (2006-2007). PATIENTS: We examined 165,447 patients with diabetes defined using clinical registries. Our study included both patients with diabetes-only and patients with multiple complex chronic conditions (diabetes plus asthma, congestive artery disease, congestive heart failure, or hypertension). MEASUREMENTS: We examined rates of outpatient office visits, emergency room visits, and preventable hospitalizations (for ambulatory care sensitive conditions).
resultsAccess to a patient portal was associated with significantly higher rates of outpatient office visits, in both patients with diabetes only and in patients with multiple complex conditions (p<0.05). In patients with multiple complex chronic conditions, portal use was also associated with significantly fewer emergency room visits (3.9 fewer per 1,000 patients per month, p<0.05) and preventable hospital stays (0.8 fewer per 1,000 patients per month, p<0.05). In patients with only diabetes, the results were directionally consistent but not statistically significantly associated with emergency room visits and preventable hospital stays. LIMITATIONS: Observational study in an integrated delivery system.
conclusionAccess to a patient portal can increase engagement in outpatient visits, potentially addressing unmet clinical needs, and reduce downstream health events that lead to emergency and hospital care, particularly among patients with multiple complex conditions.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.