IDEAS home Printed from https://ideas.repec.org/p/hhs/gunwpe/0808.html

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

Author

Listed:
  • Ellegård, Lina Maria

    (Dept of Economics, Lund University, Sweden)

  • Kjellsson, Gustav

    (Department of Economics, School of Business, Economics and Law, Göteborg University)

  • Mattisson, Linn

    (Dept of Economics, Lund University, Sweden)

Abstract

The emergence of markets for on-demand online physician consultations –direct-to-consumer telemedicine (DCT) – is currently transforming many healthcare settings. DCT may be a cost-effective substitute for ordinary consultations, but the convenience of seeking DCT may increase demand and costs for health insurers. To causally assess to which degree DCT consultations substitute for in-person consultations, we exploit exogenous changes in patient fees in a fuzzy difference-in-discontinuities analysis of young adults in Sweden. We estimate a degree of substitution of 45%, implying an increase in the consultation volume. Characteristics of the additional demand raise concerns related to healthcare equity, efficiency and costs.

Suggested Citation

  • Ellegård, Lina Maria & Kjellsson, Gustav & Mattisson, Linn, 2021. "An App Call a Day Keeps the Patient Away? Substitution of Online and In-Person Doctor Consultations Among Young Adults," Working Papers in Economics 808, University of Gothenburg, Department of Economics, revised May 2022.
    • Handle: RePEc:hhs:gunwpe:0808
    as

    Download full text from publisher

    File URL: https://gupea.ub.gu.se/handle/2077/68545
    File Function: Full text
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Naimi Johansson & Niklas Jakobsson & Mikael Svensson, 2019. "Effects of primary care cost-sharing among young adults: varying impact across income groups and gender," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1271-1280, November.
    2. Brian Baugh & Itzhak Ben‐David & Hoonsuk Park, 2018. "Can Taxes Shape an Industry? Evidence from the Implementation of the “Amazon Tax”," Journal of Finance, American Finance Association, vol. 73(4), pages 1819-1855, August.
    3. Matias D. Cattaneo & Nicolas Idrobo & Rocio Titiunik, 2019. "A Practical Introduction to Regression Discontinuity Designs: Foundations," Papers 1911.09511, arXiv.org.
    4. Hessam Bavafa & Lorin M. Hitt & Christian Terwiesch, 2018. "The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care," Management Science, INFORMS, vol. 64(12), pages 5461-5480, December.
    5. Yang He & Otávio Bartalotti, 2020. "Wild bootstrap for fuzzy regression discontinuity designs: obtaining robust bias-corrected confidence intervals," The Econometrics Journal, Royal Economic Society, vol. 23(2), pages 211-231.
    6. Lee, David S. & Card, David, 2008. "Regression discontinuity inference with specification error," Journal of Econometrics, Elsevier, vol. 142(2), pages 655-674, February.
    7. Björn Ekman, 2018. "Cost Analysis of a Digital Health Care Model in Sweden," PharmacoEconomics - Open, Springer, vol. 2(3), pages 347-354, September.
    8. Hector Galindo Silva; Nibene Habib Somé; Guy Tchuente & Nibene Habib Som� & Guy Tchuente, 2019. "Does Obamacare Care? A Fuzzy Difference-in-discontinuities Approach," Vniversitas Económica, Universidad Javeriana - Bogotá, vol. 0(0), pages 1-47.
    9. Heckley, Gawain & Gerdtham, Ulf-G. & Jarl, Johan, 2018. "Too Young to Die: Regression Discontinuity of a Two-Part Minimum Legal Drinking Age Policy and the Causal Effect of Alcohol on Health," Working Papers 2018:4, Lund University, Department of Economics.
    10. Nilsson, Anton & Paul, Alexander, 2018. "Patient cost-sharing, socioeconomic status, and children's health care utilization," Journal of Health Economics, Elsevier, vol. 59(C), pages 109-124.
    11. Guido Imbens & Karthik Kalyanaraman, 2012. "Optimal Bandwidth Choice for the Regression Discontinuity Estimator," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 79(3), pages 933-959.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hsing-Wen Han & Hsien-Ming Lien & Tzu-Ting Yang, 2020. "Patient Cost-Sharing and Healthcare Utilization in Early Childhood: Evidence from a Regression Discontinuity Design," American Economic Journal: Economic Policy, American Economic Association, vol. 12(3), pages 238-278, August.
    2. Mauricio Villamizar‐Villegas & Freddy A. Pinzon‐Puerto & Maria Alejandra Ruiz‐Sanchez, 2022. "A comprehensive history of regression discontinuity designs: An empirical survey of the last 60 years," Journal of Economic Surveys, Wiley Blackwell, vol. 36(4), pages 1130-1178, September.
    3. Le, Dung D. & Nguyen, Minh T. & Ibuka, Yoko, 2025. "Intergenerational effects of education on child mortality: Evidence from the compulsory primary schooling law in Vietnam," World Development, Elsevier, vol. 185(C).
    4. Naimi Johansson & Niklas Jakobsson & Mikael Svensson, 2019. "Effects of primary care cost-sharing among young adults: varying impact across income groups and gender," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(8), pages 1271-1280, November.
    5. Matias D. Cattaneo & Rocío Titiunik, 2022. "Regression Discontinuity Designs," Annual Review of Economics, Annual Reviews, vol. 14(1), pages 821-851, August.
    6. Carolina Caetano & Gregorio Caetano & Juan Carlos Escanciano, 2023. "Regression discontinuity design with multivalued treatments," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 38(6), pages 840-856, September.
    7. Chen, Yi & Zhao, Yi, 2022. "The timing of first marriage and subsequent life outcomes: Evidence from a natural experiment," Journal of Comparative Economics, Elsevier, vol. 50(3), pages 713-731.
    8. Maria Alice Moz-Christofoletti & Paula Carvalho Pereda & Wesley Campanharo, 2022. "Does Decentralized and Voluntary Commitment Reduce Deforestation? The Effects of Programa Municípios Verdes," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 82(1), pages 65-100, May.
    9. Shaun M. Dougherty, 2018. "The Effect of Career and Technical Education on Human Capital Accumulation: Causal Evidence from Massachusetts," Education Finance and Policy, MIT Press, vol. 13(2), pages 119-148, Spring.
    10. Eduardo Fé & Bruce Hollingsworth, 2016. "Short- and long-run estimates of the local effects of retirement on health," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 1051-1067, October.
    11. Salman, Muhammad & Long, Xingle & Wang, Guimei & Zha, Donglan, 2022. "Paris climate agreement and global environmental efficiency: New evidence from fuzzy regression discontinuity design," Energy Policy, Elsevier, vol. 168(C).
    12. Otávio Bartalotti, 2013. "Theory and Practice of Inference in Regression Discontinuity: A Fixed-Bandwidth Asymptotics Approach," Working Papers 1302, Tulane University, Department of Economics, revised Nov 2013.
    13. Erten, Bilge & Keskin, Pinar, 2019. "Compulsory schooling for whom? The role of gender, poverty, and religiosity," Economics of Education Review, Elsevier, vol. 72(C), pages 187-203.
    14. María F. Prada & Graciana Rucci & Sergio S. Urzúa, 2015. "The Effect of Mandated Child Care on Female Wages in Chile," NBER Working Papers 21080, National Bureau of Economic Research, Inc.
    15. Benjamin Castleman & Joshua Goodman, 2018. "Intensive College Counseling and the Enrollment and Persistence of Low-Income Students," Education Finance and Policy, MIT Press, vol. 13(1), pages 19-41, Winter.
    16. David S. Lee & Thomas Lemieux, 2010. "Regression Discontinuity Designs in Economics," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 281-355, June.
    17. Joaquín Artés & Ignacio Jurado, 2018. "Government fragmentation and fiscal deficits: a regression discontinuity approach," Public Choice, Springer, vol. 175(3), pages 367-391, June.
    18. David Wilkinson & Rebecca Riley, 2011. "The UK Minimum Wage at Age 22: A Regression Discontinuity Approach," National Institute of Economic and Social Research (NIESR) Discussion Papers 378, National Institute of Economic and Social Research.
    19. Alessio Gaggero & Getinet Haile, 2020. "Does class size matter in postgraduate education?," Manchester School, University of Manchester, vol. 88(3), pages 489-505, June.
    20. Zhao, Meng & Konishi, Yoshifumi & Noguchi, Haruko, 2017. "Retiring for better health? Evidence from health investment behaviors in Japan," Japan and the World Economy, Elsevier, vol. 42(C), pages 56-63.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:gunwpe:0808. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Jessica Oscarsson (email available below). General contact details of provider: https://edirc.repec.org/data/naiguse.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.