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Online Doctors – popular but price-sensitive for young people

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Young adults are more likely to consume healthcare when it is available via healthcare apps, and even more so if they do not have to pay patient fees. This has been shown in a study carried out at the University of Gothenburg.

The emergence of online healthcare via mobile apps has brought about changes in the availability of and demand for healthcare. The current study, published in The Economic Journal, analyzes the consumption patterns of 19- and 20-year-olds.

The study is based on data from young people in the regions of Stockholm and Västra Götaland. During the study period, 19-year-olds were not charged a co-pay for online consultations, while 20-year-olds had to pay a fee..

Price sensitivity among patients was evident. Those who had turned 20 had on average half the number of online consultations compared to 19-year-olds. Women generally had higher consultation rates than men, and experienced a sharper decline once they turned 20.

The value of easing worries

“People often seek online healthcare for simple ailments, a type of care for which price generally matters more,” says Gustav Kjellsson, a researcher in health economics at the University of Gothenburg. “This doesn’t necessarily mean that it is unwarranted care. It’s important to bear in mind that without access to medical expertise, it is difficult to determine which healthcare needs you actually have. Easing people’s worries also has a value.”

The researchers estimate that 45% of the online consultations by 19-year-olds substituted a physical visit, while the remaining 55% represented care that would not have taken place without easy access to online care. 

“These often relate to respiratory infections, skin conditions, and healthcare related to sexual and reproductive health, such as contraceptive management, which would typically be handled by a midwife,” he continues. “What we are seeing is a shift toward more care provided by doctors.”

Cost-neutral increase in volume

The researchers found no measurable negative medical effects from the shift toward more online and fewer in-person consultations, either on follow-up care or complication rates. A secondary finding is that young men, who are generally less inclined to seek healthcare, increased their visits to youth clinics.

“This may be an effect of an initial online doctor consultation,” says Gustav Kjellsson. “Accessibility may make it easier to seek help for conditions that are sensitive in nature, such as sexually transmitted diseases.”

The Swedish debate on online doctors involves quality of healthcare, resource allocation, the extent to which the burden on primary care is relieved, and not least how the regions reimburse private online doctor consultations. Against this background, there is another finding in the study that the researchers say stands out: The increased consumption of health care among 19- and 20-year-olds did not result in higher total production costs.

“Interestingly, our estimates indicate that the increased volume of healthcare is more or less cost neutral. The regions’ costs for digital healthcare are not primarily due to production costs, but to the reimbursement models of private online consultation.”

Authors in the study are Gustav Kjellsson, Institute of Medicine at Sahlgrenska Academy and Centre for Health Governance, University of Gothenburg, and Lina Maria Ellegård and Linn Mattisson, Department of Economics at Lund University.
Photo: Isac Lundmark, Johan Persson, Private

Study: An App Call a Day Keeps the Patient Away? Substitution of Online and In-Person Doctor Consultations Among Young Adults