title: Personal health record use for children and health care utilization: propensity score-matched cohort analysis.
abstract: OBJECTIVE
  To examine the association between caregiver personal health record (PHR) use and health care utilization by pediatric patients.
  
  
  METHODS
  We conducted a retrospective observational cohort study of 2286 pediatric members aged six months to 2.5 years of Kaiser Permanente Hawaii and Northwest Regions in 2007-2011, using propensity score matching methods and t and chi-square tests to examine associations between PHR use and health care utilization. We used ANOVA to examine utilization across quartiles of PHR use.
  
  
  METHODS
  Outpatient clinic visits, telephone encounters, and emergency department visits.
  
  
  RESULTS
  PHR-registered children, compared with propensity score-matched nonregistered children, had 21% (95% CI, 14-28; P < .0001) more outpatient clinic visits and 26% (95% CI, 16-37; P < .0001) more telephone encounters. Utilization differences were more pronounced with nonprimary care providers than with primary care providers. Outpatient clinic visits and telephone encounters increased among the quartile with the highest PHR use; no utilization differences occurred in the 3 lowest-use quartiles.
  
  
  CONCLUSIONS
  PHR use by caregivers was associated with statistically significant increases in outpatient clinic visits and telephone encounters among pediatric patients.
authors: Northwest Permanente, Innovation and Care Transformation, Portland, Oregon, USA yvonne.y.zhou@kp.org.
authors: Yi Yvonne
authors: YY
authors: Zhou
authors: Northwest Permanente, Innovation and Care Transformation, Portland, Oregon, USA.
authors: Wendy M
authors: WM
authors: Leith
authors: Northwest Permanente, Health Intelligence & Analytics, Portland, Oregon, USA.
authors: Hui
authors: H
authors: Li
authors: Kaiser Permanente Center for Health Research-Hawaii and Department of Pediatrics, Hawaii Permanente Medical Group, 501 Alakawa Street, Honolulu, Hawaii, USA 96817.
authors: Jeffrey O
authors: JO
authors: Tom
mesh_terms: D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D017028:Caregivers; D002675:Child, Preschool; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D007223:Infant; D008297:Male; D010342:Patient Acceptance of Health Care; D057216:Propensity Score; D012189:Retrospective Studies
keywords: ambulatory care; electronic health record; pediatrics; personal electronic health record; utilization
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