Department of Public Health, University of Helsinki, Helsinki, Finland.
Department of Economics, Jyväskylä University School of Business and Economics (JSBE), Finland.
Scand J Prim Health Care. 2024 Dec;42(4):686-694. doi: 10.1080/02813432.2024.2380921. Epub 2024 Jul 21.
OBJECTIVES: This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting. DESIGN: The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits. SETTING: Primary health care. PARTICIPANTS: The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services. MAIN OUTCOME MEASURES: The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization. RESULTS: Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments. CONCLUSION: Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.
目的:本研究比较了在初级保健环境中,使用数字全科医生(GP)就诊的患者与选择传统面对面预约就诊的患者的人口统计学特征、诊断、再入院率、病假和处方药物情况。
设计:本研究采用回顾性分析 2019 年收集的患者记录数据,比较了数字初级保健中心和传统保健中心的就诊情况。
设置:初级保健。
参与者:数据包括使用数字诊所的患者和到公共卫生中心就诊的患者。
主要观察指标:本研究评估了人口统计学特征、健康诊断、处方药物、病假建议、再入院率以及数字诊所和面对面就诊之间的成本差异。次要结果包括对药物类别、健康问题解决率以及对医疗保健利用潜在影响的比较分析。
结果:与卫生中心使用者相比,数字诊所使用者通常更年轻、受教育程度更高且以女性为主。数字就诊适合治疗简单感染,而卫生中心就诊则与更高的慢性病患病率相关。两种模式的药物模式不同,数字诊所使用者接受非处方通用药物和抗生素,而卫生中心就诊则通常涉及心脏和抗高血压药物。数字诊所的病假建议略高,但差异无统计学意义。数字诊所处理的约 70%的健康问题得到成功解决,且数字就诊的费用约为面对面就诊的 50.3%。
结论:与公共卫生中心的使用者相比,数字医疗保健服务为特定健康问题提供了一种具有成本效益的替代方案,对年轻、受教育程度较高的个体具有吸引力,并且可能在结合可接受的需求管理和患者细分实践的情况下提高成本效益。结果突出了数字诊所的潜在益处,特别是对于简单病例,同时也强调了适当的转介机制对于面对面咨询的重要性。
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