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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
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    File URL: https://gupea.ub.gu.se/handle/2077/68545
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    References listed on IDEAS

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    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. 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.
    4. Hector Galindo Silva; Nibene Habib Somé; Guy Tchuente & Nibene Habib Somé & Guy Tchuente, 2019. "Does Obamacare Care? A Fuzzy Difference-in-discontinuities Approach," Vniversitas Económica 17211, Universidad Javeriana - Bogotá.
    5. Matias D. Cattaneo & Nicolas Idrobo & Rocio Titiunik, 2019. "A Practical Introduction to Regression Discontinuity Designs: Foundations," Papers 1911.09511, arXiv.org.
    6. 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.
    7. Yang He & Otávio Bartalotti, 2020. "Wild bootstrap for fuzzy regression discontinuity designs: obtaining robust bias-corrected confidence intervals [Using Maimonides’ rule to estimate the effect of class size on scholastic achievemen," The Econometrics Journal, Royal Economic Society, vol. 23(2), pages 211-231.
    8. Lee, David S. & Card, David, 2008. "Regression discontinuity inference with specification error," Journal of Econometrics, Elsevier, vol. 142(2), pages 655-674, February.
    9. Björn Ekman, 2018. "Cost Analysis of a Digital Health Care Model in Sweden," PharmacoEconomics - Open, Springer, vol. 2(3), pages 347-354, September.
    10. 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.
    11. 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.
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    More about this item

    Keywords

    telemedicine; primary health care; co-payments; regression discontinuity design;
    All these 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

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