Customizing Primary Care Delivery Using E-Visits

• 成果类型: Article
• 署名作者: Bavafa, Hessam; Savin, Sergei; Terwiesch, Christian
• 署名单位: University of Wisconsin System; University of Wisconsin Madison; University of Wisconsin System; University of Wisconsin Madison; University of Pennsylvania; University of Pennsylvania
• 刊物名称: PRODUCTION AND OPERATIONS MANAGEMENT
• ISSN/ISSBN: 1059-1478
• DOI: 10.1111/poms.13528
• 发表日期: 2021
• 页码: 4306-4327
• 关键词: telemedicine; Healthcare; service operations; information technology policy and management; CONTRACTS

摘要

Technologies that enable e-visits-remote interactions between patients and physicians-are touted as a way to improve and expand primary care. We study a setting in which a physician can divert some of the patient demand away from the office visits and into the e-visits, which utilize less of the physician's service capacity while maintaining an appropriate quality of care. We explicitly model a distinguishing feature of primary care settings: patient office revisit intervals are determined jointly by the physician and her patients. Using our model, we identify settings where patients and physicians adopt e-visits. We analytically characterize the impact of e-visits on key system outcomes: panel size, patient health, and physician compensation. Notably, we identify settings-defined in terms of patient panel features, parameters of primary care delivery, and physician compensation scheme-in which at least one of the system outcomes suffers under e-visits. Our modeling approach highlights the importance of considering patient and physician responses to primary care interventions to understand their full impact.