Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide
BackgroundDigital patient portals (PPs) are platforms that enhance patient engagement and promote active involvement in health care by providing remote access to personal health data. Although many hospitals are legally required to offer these portals, adoption varies widely...
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JMIR Publications
2025-06-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2025/1/e68091 |
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| author | Nina Goldberg Christin Herrmann Paola Di Gion Volker Hautsch Klara Hefter Georg Langebartels Holger Pfaff Lena Ansmann Ute Karbach Florian Wurster |
| author_facet | Nina Goldberg Christin Herrmann Paola Di Gion Volker Hautsch Klara Hefter Georg Langebartels Holger Pfaff Lena Ansmann Ute Karbach Florian Wurster |
| author_sort | Nina Goldberg |
| collection | DOAJ |
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BackgroundDigital patient portals (PPs) are platforms that enhance patient engagement and promote active involvement in health care by providing remote access to personal health data. Although many hospitals are legally required to offer these portals, adoption varies widely among patients, often influenced by sociodemographic and socioeconomic determinants. Evidence suggests that higher income, education, employment status, and specific age groups correlate with increased portal usage, highlighting a digital divide. This study aims to analyze sociodemographic and socioeconomic determinants affecting digital PP usage, addressing inconsistencies in existing research and contributing to strategies for reducing digital health disparities.
ObjectiveThis study aimed to conduct a meta-analysis of the sociodemographic and socioeconomic factors contributing to the digital divide in the usage of digital PPs.
MethodsA systematic review with meta-analysis was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in PubMed, Web of Science Core Collection, and EBSCOhost. Screening involved 3 reviewers with consensus meetings to resolve discrepancies. Data on sociodemographic and socioeconomic factors and statistical outcomes were extracted, and study quality was assessed using the Mixed Methods Appraisal tool. Results were visualized using forest and funnel plots to assess heterogeneity and publication bias.
ResultsA total of 2225 studies were identified through a systematic review, and after title and abstract screening, 17 studies were included in the quantitative and qualitative analysis. The qualitative analysis revealed that younger patients (younger than 65 y) were significantly more likely to use the digital PP, while the meta-analysis revealed that women had a 16% higher likelihood of using the digital PP than men. The relationship between income and digital PP usage was inconsistent, due to different scaling in different studies. A higher level of education was significantly associated with a 37% greater likelihood of using the digital PP in the meta-analysis. In addition, employed patients were 23% more likely to use the digital PP, while married patients had a 13% higher likelihood of using it than unmarried patients. Marital status and employment can be considered as measurable factors of social relationships.
ConclusionsThe review confirms that sociodemographic and socioeconomic factors significantly influence the usage of digital PP in hospital care. Marital status shows that social support plays a vital role, with married patients 13% more likely to engage with digital PPs. It is worth noting that social support through connections to society via work or work colleagues can also play an important role as like as a partner at home, with employed individuals being 22% more likely to use digital PPs. Overall, sociodemographic factors, like marital status, primarily affect usage patterns, while socioeconomic factors, like employment, enable access, emphasizing the need for comprehensive support systems to bridge the digital divide in health care.
Trial RegistrationGerman register of clinical trials DRKS00033125; https://drks.de/search/de/trial/DRKS00033125 and PROSPERO CRD42024567203; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024567203 |
| format | Article |
| id | doaj-art-cc67d504bda7473d95ff68982c6e7f2e |
| institution | DOAJ |
| issn | 1438-8871 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj-art-cc67d504bda7473d95ff68982c6e7f2e2025-08-20T03:07:37ZengJMIR PublicationsJournal of Medical Internet Research1438-88712025-06-0127e6809110.2196/68091Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital DivideNina Goldberghttps://orcid.org/0009-0005-1095-5171Christin Herrmannhttps://orcid.org/0000-0003-1986-7512Paola Di Gionhttps://orcid.org/0009-0008-0265-539XVolker Hautschhttps://orcid.org/0009-0003-8954-8311Klara Hefterhttps://orcid.org/0009-0007-9307-0137Georg Langebartelshttps://orcid.org/0000-0002-2448-2433Holger Pfaffhttps://orcid.org/0000-0001-9154-6575Lena Ansmannhttps://orcid.org/0000-0002-8628-7166Ute Karbachhttps://orcid.org/0000-0003-3479-9474Florian Wursterhttps://orcid.org/0000-0001-5527-9238 BackgroundDigital patient portals (PPs) are platforms that enhance patient engagement and promote active involvement in health care by providing remote access to personal health data. Although many hospitals are legally required to offer these portals, adoption varies widely among patients, often influenced by sociodemographic and socioeconomic determinants. Evidence suggests that higher income, education, employment status, and specific age groups correlate with increased portal usage, highlighting a digital divide. This study aims to analyze sociodemographic and socioeconomic determinants affecting digital PP usage, addressing inconsistencies in existing research and contributing to strategies for reducing digital health disparities. ObjectiveThis study aimed to conduct a meta-analysis of the sociodemographic and socioeconomic factors contributing to the digital divide in the usage of digital PPs. MethodsA systematic review with meta-analysis was conducted using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines in PubMed, Web of Science Core Collection, and EBSCOhost. Screening involved 3 reviewers with consensus meetings to resolve discrepancies. Data on sociodemographic and socioeconomic factors and statistical outcomes were extracted, and study quality was assessed using the Mixed Methods Appraisal tool. Results were visualized using forest and funnel plots to assess heterogeneity and publication bias. ResultsA total of 2225 studies were identified through a systematic review, and after title and abstract screening, 17 studies were included in the quantitative and qualitative analysis. The qualitative analysis revealed that younger patients (younger than 65 y) were significantly more likely to use the digital PP, while the meta-analysis revealed that women had a 16% higher likelihood of using the digital PP than men. The relationship between income and digital PP usage was inconsistent, due to different scaling in different studies. A higher level of education was significantly associated with a 37% greater likelihood of using the digital PP in the meta-analysis. In addition, employed patients were 23% more likely to use the digital PP, while married patients had a 13% higher likelihood of using it than unmarried patients. Marital status and employment can be considered as measurable factors of social relationships. ConclusionsThe review confirms that sociodemographic and socioeconomic factors significantly influence the usage of digital PP in hospital care. Marital status shows that social support plays a vital role, with married patients 13% more likely to engage with digital PPs. It is worth noting that social support through connections to society via work or work colleagues can also play an important role as like as a partner at home, with employed individuals being 22% more likely to use digital PPs. Overall, sociodemographic factors, like marital status, primarily affect usage patterns, while socioeconomic factors, like employment, enable access, emphasizing the need for comprehensive support systems to bridge the digital divide in health care. Trial RegistrationGerman register of clinical trials DRKS00033125; https://drks.de/search/de/trial/DRKS00033125 and PROSPERO CRD42024567203; https://www.crd.york.ac.uk/PROSPERO/view/CRD42024567203https://www.jmir.org/2025/1/e68091 |
| spellingShingle | Nina Goldberg Christin Herrmann Paola Di Gion Volker Hautsch Klara Hefter Georg Langebartels Holger Pfaff Lena Ansmann Ute Karbach Florian Wurster Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide Journal of Medical Internet Research |
| title | Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide |
| title_full | Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide |
| title_fullStr | Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide |
| title_full_unstemmed | Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide |
| title_short | Sociodemographic and Socioeconomic Determinants for the Usage of Digital Patient Portals in Hospitals: Systematic Review and Meta-Analysis on the Digital Divide |
| title_sort | sociodemographic and socioeconomic determinants for the usage of digital patient portals in hospitals systematic review and meta analysis on the digital divide |
| url | https://www.jmir.org/2025/1/e68091 |
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