Rodrigues Daniela, Kreif Noemi, Darzi Ara, Barahona Mauricio, Mayer Erik
Department of Surgery & Cancer, NIHR North West London Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, UK.
The School of Pharmacy, Department of Pharmacy, The CHOICE Institute, University of Washington, Seattle, Washington, USA.
Health Econ. 2025 Oct;34(10):1943-1962. doi: 10.1002/hec.70014. Epub 2025 Jul 17.
In the English National Health Service, most patients can use an online platform to send a written request to the practice, in addition to calling or visiting the practice in person. However, there are concerns that the availability of an online access route to primary care can adversely impact healthcare provision for older or lower socioeconomic groups. To examine those concerns, we explore the differential timing of online platforms' implementation between 2019 and 2020 across 289 practices covering over 2.5 million patients in North West London. We find no evidence of an impact of the online access route on age and socioeconomic-related inequity in synchronous interactions in primary care, but observe an increase in all interactions in this setting and in some cases, a small reduction (worst case, no changes) in unplanned hospital care. These findings suggest that having an online access route to primary care can improve the provision of healthcare services, at no detriment to patients from older and lower socioeconomic groups.
在英国国家医疗服务体系中，除了亲自致电或前往诊所外，大多数患者还可以使用在线平台向诊所发送书面请求。然而，有人担心通过在线途径获取初级医疗服务可能会对老年或社会经济地位较低的群体的医疗服务提供产生不利影响。为了研究这些担忧，我们探讨了2019年至2020年期间伦敦西北部289家诊所（覆盖超过250万患者）实施在线平台的不同时间。我们没有发现在线途径对初级医疗同步互动中与年龄和社会经济相关的不平等产生影响的证据，但观察到这种情况下所有互动都有所增加，在某些情况下，非计划住院治疗略有减少（最糟糕的情况是没有变化）。这些发现表明，通过在线途径获取初级医疗服务可以改善医疗服务的提供，而不会对老年和社会经济地位较低群体的患者造成损害。
