Scandinavian Working Papers in Economics

Working Papers in Economics,
University of Gothenburg, Department of Economics

No 808: An App Call a Day Keeps the Patient Away? Substitution of Online and In-Person Doctor Consultations Among Young Adults

Lina Maria Ellegård (), Gustav Kjellsson () and Linn Mattisson ()
Additional contact information
Lina Maria Ellegård: Dept of Economics, Lund University, Sweden
Gustav Kjellsson: Department of Economics, School of Business, Economics and Law, Göteborg University, Postal: P.O. Box 640, SE 40530 GÖTEBORG, Sweden
Linn Mattisson: 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.

Keywords: telemedicine; primary health care; co-payments; regression discontinuity design

JEL-codes: I11; I12; I18

Language: English

97 pages, First version: June 2021. Revised: May 2022.

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