A Note on the Effects of Digital Primary Health Care on Utilization: Concepts, Evidence, and Descriptive Analysis of Non-Experimental Register Data from Sweden

Digital technologies for health care may lower costs while enhancing access to services. However, concerns have been raised that digital care may lead to over-use of services and not be as effective as in-person visits. Previous studies have found varying effects across different contexts, study designs, and outcome measures. This study contributes to the emerging evidence on the effects of digital care on primary care utilization by developing a conceptual model for primary care use and then comparing the effects of digital primary care with in-person visits and telephone contacts. Register data from Sweden over a two-year period (2017-2018) in a sample of patients diagnosed with an infection are used to describe the effects. Findings show that the majority of patients require a single consultation across either model of care. A relatively small share of patients makes multiple consultations per episode of care both across and within models of care. Compared with in-person visits and telephone contacts, digital care is associated with fewer consultations per episode of care and involve lower rates of laboratory tests and antibiotic prescriptions. Digital care is provided by a physician to a larger extent compared with the other models of care in the current sample. Further analysis will be conducted to establish any causal effects of digital primary contacts on identified outcomes.