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Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden

BACKGROUND: In recent years, telemedicine consultations have evolved as a new form of providing primary healthcare. Telemedicine options can provide benefits to patients in terms of access, reduced travel time and no risk of disease spreading. However, concerns have been raised that access is not eq...

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Autores principales: Dahlgren, Cecilia, Dackehag, Margareta, Wändell, Per, Rehnberg, Clas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233176/
https://www.ncbi.nlm.nih.gov/pubmed/34172009
http://dx.doi.org/10.1186/s12875-021-01481-1
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author Dahlgren, Cecilia
Dackehag, Margareta
Wändell, Per
Rehnberg, Clas
author_facet Dahlgren, Cecilia
Dackehag, Margareta
Wändell, Per
Rehnberg, Clas
author_sort Dahlgren, Cecilia
collection PubMed
description BACKGROUND: In recent years, telemedicine consultations have evolved as a new form of providing primary healthcare. Telemedicine options can provide benefits to patients in terms of access, reduced travel time and no risk of disease spreading. However, concerns have been raised that access is not equally distributed in the population, which could lead to increased inequality in health. The aim of this paper is to explore the determinants for use of direct-to-consumer (DTC) telemedicine consultations in a setting where telemedicine is included in the publicly funded healthcare system. METHODS: To investigate factors associated with the use of DTC telemedicine, a database was constructed by linking national and regional registries covering the entire population of Stockholm, Sweden (N = 2.3 million). Logistic regressions were applied to explore the determinants for utilization in 2018. As comparators, face-to-face physician consultations in primary healthcare were included in the study, as well as digi-physical physician consultations, i.e., telemedicine consultations offered by traditional primary healthcare providers also offering face-to-face visits, and telephone consultations by nurses. RESULTS: The determinants for use of DTC telemedicine differed substantially from face-to-face visits but also to some extent from the other telemedicine options. For the DTC telemedicine consultations, the factors associated with higher probability of utilization were younger age, higher educational attainment, higher income and being born in Sweden. In contrast, the main determinants for use of face-to-face visits were higher age, lower educational background and being born outside of Sweden. CONCLUSION: The use of DTC telemedicine is determined by factors that are generally not associated with greater healthcare need and the distribution raises some concerns about the equity implications. Policy makers aiming to increase the level of telemedicine consultations in healthcare should consider measures to promote access for elderly and individuals born outside of Sweden to ensure that all groups have access to healthcare services according to their needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-021-01481-1.
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spelling pubmed-82331762021-06-28 Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden Dahlgren, Cecilia Dackehag, Margareta Wändell, Per Rehnberg, Clas BMC Fam Pract Research BACKGROUND: In recent years, telemedicine consultations have evolved as a new form of providing primary healthcare. Telemedicine options can provide benefits to patients in terms of access, reduced travel time and no risk of disease spreading. However, concerns have been raised that access is not equally distributed in the population, which could lead to increased inequality in health. The aim of this paper is to explore the determinants for use of direct-to-consumer (DTC) telemedicine consultations in a setting where telemedicine is included in the publicly funded healthcare system. METHODS: To investigate factors associated with the use of DTC telemedicine, a database was constructed by linking national and regional registries covering the entire population of Stockholm, Sweden (N = 2.3 million). Logistic regressions were applied to explore the determinants for utilization in 2018. As comparators, face-to-face physician consultations in primary healthcare were included in the study, as well as digi-physical physician consultations, i.e., telemedicine consultations offered by traditional primary healthcare providers also offering face-to-face visits, and telephone consultations by nurses. RESULTS: The determinants for use of DTC telemedicine differed substantially from face-to-face visits but also to some extent from the other telemedicine options. For the DTC telemedicine consultations, the factors associated with higher probability of utilization were younger age, higher educational attainment, higher income and being born in Sweden. In contrast, the main determinants for use of face-to-face visits were higher age, lower educational background and being born outside of Sweden. CONCLUSION: The use of DTC telemedicine is determined by factors that are generally not associated with greater healthcare need and the distribution raises some concerns about the equity implications. Policy makers aiming to increase the level of telemedicine consultations in healthcare should consider measures to promote access for elderly and individuals born outside of Sweden to ensure that all groups have access to healthcare services according to their needs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-021-01481-1. BioMed Central 2021-06-26 /pmc/articles/PMC8233176/ /pubmed/34172009 http://dx.doi.org/10.1186/s12875-021-01481-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Dahlgren, Cecilia
Dackehag, Margareta
Wändell, Per
Rehnberg, Clas
Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title_full Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title_fullStr Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title_full_unstemmed Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title_short Determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from Stockholm, Sweden
title_sort determinants for use of direct-to-consumer telemedicine consultations in primary healthcare—a registry based total population study from stockholm, sweden
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233176/
https://www.ncbi.nlm.nih.gov/pubmed/34172009
http://dx.doi.org/10.1186/s12875-021-01481-1
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