Table 2. Factors Associated With Smartphone-Only Internet Access and Patient Portal Use, 2017-2020.
| Variable | Smartphone-only internet access (n = 8790) | Patient portal use (n = 8790) | ||
|---|---|---|---|---|
| OR (95% CI) | P value | OR (95% CI) | P value | |
| Smartphone only | ||||
| Yes | NA | NA | 0.82 (0.74-0.91) | <.001 |
| No | NA | NA | 1 [Reference] | NA |
| Uses internet to view health information | ||||
| Yes | 0.92 (0.67-1.26) | .60 | 2.66 (2.33-3.05) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Usual source of carea | ||||
| Yes | 0.85 (0.70-1.04) | .12 | 1.90 (1.69-2.13) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Uninsured | ||||
| Yes | 0.87 (0.54-1.41) | .58 | 0.51 (0.38-0.68) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Age, y | ||||
| 18-34 | 1 [Reference] | NA | 1 [Reference] | NA |
| 35-49 | 0.37 (0.30-0.46) | <.001 | 0.92 (0.79-1.07) | .28 |
| 50-64 | 0.31 (0.25-0.39) | <.001 | 0.92 (0.80-1.06) | .26 |
| 65-74 | 0.24 (0.19-0.30) | <.001 | 0.95 (0.81-1.12) | .57 |
| ≥75 | 0.12 (0.09-0.17) | <.001 | 0.69 (0.56-0.85) | .001 |
| Sex | ||||
| Men | 0.48 (0.40-0.58) | <.001 | 0.69 (0.63-0.76) | <.001 |
| Women | 1 [Reference] | NA | 1 [Reference] | NA |
| Race/ethnicity | ||||
| Non-Hispanic White | 1 [Reference] | NA | 1 [Reference] | NA |
| Non-Hispanic Black | 1.32 (1.01-1.72) | .04 | 0.92 (0.81-1.05) | .21 |
| Hispanic | 1.33 (1.04-1.72) | .03 | 0.85 (0.73-0.98) | .03 |
| Other | 0.80 (0.60-1.08) | .15 | 1.00 (0.85-1.17) | .97 |
| Income, $ | ||||
| <20 000 | 1 [Reference] | NA | 1 [Reference] | NA |
| 20 000-34 999 | 0.62 (0.43-0.90) | .01 | 1.06 (0.88-1.29) | .53 |
| 35 000-49 999 | 0.61 (0.43-0.88) | .009 | 1.50 (1.24-1.82) | <.001 |
| 50 000-74 999 | 0.60 (0.45-0.81) | .001 | 1.56 (1.31-1.87) | <.001 |
| ≥75 000 | 0.57 (0.40-0.80) | .001 | 1.93 (1.62-2.30) | <.001 |
| Education | ||||
| ≤HS diploma | 1 [Reference] | NA | 1 [Reference] | NA |
| College degree | 0.86 (0.71-1.05) | .14 | 1.35 (1.21-1.50) | <.001 |
| Postgraduate | 0.72 (0.58-0.89) | .002 | 1.51 (1.34-1.70) | <.001 |
| Married | ||||
| Yes | 1.00 (0.83-1.20) | .98 | 1.11 (1.01-1.23) | .04 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Rural residence | ||||
| Yes | 1.13 (0.89-1.45) | .32 | 0.76 (0.66-0.88) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Multiple chronic conditionsb | ||||
| Yes | 1.25 (1.02-1.52) | .03 | 1.29 (1.17-1.44) | <.001 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Deafness or hearing impairment | ||||
| Yes | 0.86 (0.57-1.29) | .46 | 1.01 (0.83-1.22) | .93 |
| No | 1 [Reference] | NA | 1 [Reference] | NA |
| Year | ||||
| 2017 | 1 [Reference] | NA | 1 [Reference] | NA |
| 2018 | 1.26 (1.01-1.57) | .04 | 1.07 (0.93-1.23) | .33 |
| 2019 | 1.44 (1.14-1.82) | .003 | 1.56 (1.37-1.77) | <.001 |
| 2020 | 1.68 (1.29-2.19) | <.001 | 1.73 (1.51-1.98) | <.001 |
| Constant | 1.89 (1.21-2.95) | .006 | 0.13 (0.10-0.16) | <.001 |
Abbreviations: HS, high school; NA, not applicable; OR, odds ratio.
a
Usual source of care refers to having a particular provider whom a patient consults when health care is needed (eg, primary care clinician).
b
Multiple chronic conditions means having 2 or more chronic conditions (diabetes, hypertension, heart condition, chronic lung disease, and depression or anxiety disorder).