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

• 成果类型: Article; Early Access
• 署名作者: Ellegard, Lina Maria; Kjellsson, Gustav; Mattisson, Linn
• 署名单位: Lund University; Kristianstad University; University of Gothenburg
• 刊物名称: ECONOMIC JOURNAL
• ISSN/ISSBN: 0013-0133
• DOI: 10.1093/ej/ueag016
• 发表日期: 2026
• 关键词: CONSUMER TELEMEDICINE VISITS; ACUTE RESPIRATORY-INFECTIONS; care; QUALITY; IMPACT

摘要

The emergence of markets for on-demand online physician consultations-direct-to-consumer telemedicine-is currently transforming many healthcare settings. Direct-to-consumer telemedicine may be a cost-effective substitute for in-person consultations, but the convenience of seeking direct-to-consumer telemedicine may increase the demand for the service and, consequently, costs for health insurers. To causally assess the degree to which direct-to-consumer telemedicine consultations substitute for in-person primary care consultations, we exploit exogenous changes in patient fees in a fuzzy difference-in-discontinuities analysis of young adults in Sweden. We estimate that 45% of direct-to-consumer telemedicine consultations replace in-person visits; the remainder represents new utilisation. We further estimate that the increase in volume could be close to cost neutral, and we find no evidence that quality deteriorates as a result of increased use of online care.