Utilization of digital primary care in Sweden: Descriptive analysis of claims data on demographics, socioeconomics, and diagnoses

Ekman, Björn; Thulesius, Hans; Wilkens, Jens; Lindgren, Anna; Cronberg, Olof; Arvidsson, Eva

doi:10.1016/j.ijmedinf.2019.04.016

Cited by 48 publications

(84 citation statements)

References 2 publications

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“…In the United States, there have been brief reports about digital primary care based on video consultations from organizations such as Kaiser Permanante [ 14 - 16 ], Jefferson Health [ 17 , 18 ], and the Veteran’s Administration [ 19 ]. Several digital health platforms have been established in Sweden, and these have been reported in a descriptive evaluation, but this does not distinguish between video, audio, and text-based web-based consultations [ 20 ]. None of these reports represent a comprehensive evaluation, and all have significant limitations, but they do provide insights into some of the controversies.…”

Section: Discussionmentioning

confidence: 99%

“…In the United Kingdom, uptake of video consultations was very low when offered by conventional general practices before the COVID-19 pandemic [ 22 , 23 ]. In Sweden, the use of digital consultations has been increasing for several years but still represented only 2% of all primary care consultations by 2017 [ 20 ]. A consistent finding has been that introduction of video consulting has been impeded by technical problems [ 23 , 24 ].…”

Section: Uptakementioning

confidence: 99%

“…In Kaiser Permanente, the use of electronic tools is highest among young adults and white patients and lower among older patients and those from African American or Latino ethnic groups [ 14 ]. In Sweden, there is a significantly positive relationship between the use of digital care and affluence [ 20 ].…”

Section: Equitymentioning

confidence: 99%

“…The current payment formula for general practice in the United Kingdom takes into account the age and sex and the health needs of a patient population at an area level, but it does not effectively adjust for the different health needs of individual patients. The problem of how to fairly reimburse health providers in ways that support the appropriate use of video consultations without increasing health system costs is being debated in the United Kingdom [ 35 , 36 ] and several countries [ 14 , 20 ]. In relation to the argument about cream-skimming, it is notable that BGPaH does not appear to attract patients who generate less work—if anything, their patients have higher consultation rates than average patients of similar age and sex, although they have fewer long-term health conditions.…”

Section: Cream-skimming?mentioning

confidence: 99%

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Private Video Consultation Services and the Future of Primary Care

Salisbury¹,

Quigley²,

Hex³

et al. 2020

J Med Internet Res

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In many countries, private companies provide primary care services based predominantly on offering video consultations via smartphones. One example is Babylon GP at Hand (BGPaH), which offers video consultations to National Health Service patients, 24 hours a day, and has grown rapidly in London over the last 3 years. The development of this type of service has been controversial, particularly in the United Kingdom, but there has been little formal published evaluation of these services in any country. This paper outlines the main controversies about the use of privately provided video consultation services for primary care and shows how they are informed by the limited evaluations that have been conducted, particularly the evaluation of BGPaH. This paper describes the advantages of these services in terms of convenience, speed of access, the ability to consult without traveling or face-to-face patient-doctor contact, and the possibility of recruiting doctors who cannot work in conventional settings or do not live near the patients. It also highlights the concerns and uncertainties about quality and safety, demand, fragmentation of care, impact on other health services, efficiency, and equity. There are questions about whether private primary care services based on video consultations have a sustainable business model and whether they will undermine other health care providers. During the recent COVID-19 pandemic, the use of video consulting has become more widespread within conventional primary care services, and this is likely to have lasting consequences for the future delivery of primary care. It is important to understand the extent to which lessons from the evaluation of BGPaH and other private services based on a video-first model are relevant to the use of video consulting within conventional general practices, and to consider the advantages and disadvantages of these developments, before video consultation–based services in primary care become more widely established.

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Section: Discussionmentioning

confidence: 99%

Section: Uptakementioning

confidence: 99%

Section: Equitymentioning

confidence: 99%

Section: Cream-skimming?mentioning

confidence: 99%

See 2 more Smart Citations

Private Video Consultation Services and the Future of Primary Care

Salisbury¹,

Quigley²,

Hex³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Previous research has also found that while digital services in health care are used in Sweden, they are more common in urban areas (Ekman et al, 2019). However, there is a lack of research from the perspective of older persons and their relatives regarding the use of ICT in health care.…”

Section: Introductionmentioning

confidence: 99%

Older persons and relatives’ experience of coordinated care planning via a video meeting

2020

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Virtual Primary Care—Is Its Expansion Due to COVID-19 All Upside?

2020

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Virtual primary care has long been promoted as the future of health care in the US. 1 Proposed benefits include improved access for rural populations, more convenient care, and reduced overhead expenses. Despite this promise, progress until recently had been slow, in part because of limited reimbursement, restrictions on where telehealth could be delivered, interstate care prohibitions, discomfort with technology, privacy concerns, and limited public enthusiasm.The US response to coronavirus disease 2019 (COVID-19) has swept many of these barriers away. 2 Medicare and private insurers now cover virtual visits, even without video. Patient costs have plummeted. Aetna, for instance, has eliminated co-payment for telemedicine visits. Platforms that are noncompliant with the Health Insurance Portability and Accountability Act, such as Skype and Zoom, can now be used. Medicare has relaxed its rules about interstate care provision and service

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Utilization of digital primary care in Sweden: Descriptive analysis of claims data on demographics, socioeconomics, and diagnoses

Cited by 48 publications

References 2 publications

Private Video Consultation Services and the Future of Primary Care

Private Video Consultation Services and the Future of Primary Care

Older persons and relatives’ experience of coordinated care planning via a video meeting

Virtual Primary Care—Is Its Expansion Due to COVID-19 All Upside?

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