Disparities in Patient Portal Access and Their Association with Perceived Health Care Quality Among U.S. Adults: A Population-Based Cross-Sectional Study

Abstract

Introduction. Patient portals are designed to improve transparency, engagement, and satisfaction with health care. However, disparities in access and encouragement to use portals persist, and their relationship with perceived care quality is not well understood. Authors of this study examined whether being offered access to a patient portal, and being encouraged to use it, were associated with higher perceived quality of care among United States adults.

Methods. The authors analyzed data from the 2024 Health Information National Trends Survey 7, a nationally representative cross-section of United States adults aged ≥18 years. Weighted analyses assessed associations between portal access offers, encouragement, and self-rated care quality in the past 12 months, adjusting for sociodemographic characteristics.

Results. Among 7,278 respondents (mean [SD] age, 49.0 [18.0] years), 78.6% rated their care as good, very good, or excellent. Overall, 73% were portal access and 69.0% were encouraged to use a portal. The number of respondents offered access to patient portal significantly was lower among older adults ≥75 years (10.6%; χ²₈=108.2, p <0.0001), women (27.9%; χ²₄=31.7, p <0.0001), those with lower income (8.3%; χ²₁₀=158.0, p <0.0001) or education (13.6%; χ²₆=107.9, p <0.0001), and rural residents (10.0%; χ²₂=12.1, p = 0.0024). In adjusted analyses, being offered portal access was associated with higher odds of rating care as excellent (aOR 2.47, 95% CI 1.21-5.07).

Conclusions. Being offered portal access independently was associated with higher perceived care quality. Addressing disparities in portal access; especially among older, lower-income, and rural populations; may improve equity in patient experience.