The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care

• 成果类型: Article
• 署名作者: Bavafa, Hessam; Hitt, Lorin M.; Terwiesch, Christian
• 署名单位: University of Wisconsin System; University of Wisconsin Madison; University of Pennsylvania; University of Pennsylvania
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.2017.2900
• 发表日期: 2018
• 页码: 5461-5480
• 关键词: Healthcare Operations; service operations; Primary care; e-visits; patient portals; empirical

摘要

Secure messaging, or e-visits, between patients and providers has sharply increased in recent years, and many hope they will help improve healthcare quality, while increasing provider capacity. Using a panel data set from a large healthcare system in the United States, we find that e-visits trigger about 6% more office visits, with mixed results on phone visits and patient health. These additional visits come at the sacrifice of new patients: physicians accept 15% fewer new patients each month following e-visit adoption. Our data set on nearly 100,000 patients spans from 2008 to 2013, which includes the rollout and diffusion of e-visits in the health system we study. Identification comes from difference-in-differences estimates leveraging variation in the timing of e-visit adoption by both patients and providers. We conduct several robustness checks, including matching analyses and an instrumental variable analysis to account for possible time-varying characteristics among patient e-visit adopters.