Daniela Rodrigues, Noemi Kreif, Ara Darzi, Mauricio Barahona, Erik Mayer
{"title":"初级保健的数字化:是否存在公平-效率的权衡?","authors":"Daniela Rodrigues, Noemi Kreif, Ara Darzi, Mauricio Barahona, Erik Mayer","doi":"10.1002/hec.70014","DOIUrl":null,"url":null,"abstract":"<p>In the English National Health Service, most patients can use an online platform to send a written request to the practice, in addition to calling or visiting the practice in person. However, there are concerns that the availability of an online access route to primary care can adversely impact healthcare provision for older or lower socioeconomic groups. To examine those concerns, we explore the differential timing of online platforms' implementation between 2019 and 2020 across 289 practices covering over 2.5 million patients in North West London. We find no evidence of an impact of the online access route on age and socioeconomic-related inequity in synchronous interactions in primary care, but observe an increase in all interactions in this setting and in some cases, a small reduction (worst case, no changes) in unplanned hospital care. These findings suggest that having an online access route to primary care can improve the provision of healthcare services, at no detriment to patients from older and lower socioeconomic groups.</p>","PeriodicalId":12847,"journal":{"name":"Health economics","volume":"34 10","pages":"1943-1962"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70014","citationCount":"0","resultStr":"{\"title\":\"Digitalization of Access to Primary Care: Is There an Equity-Efficiency Trade-Off?\",\"authors\":\"Daniela Rodrigues, Noemi Kreif, Ara Darzi, Mauricio Barahona, Erik Mayer\",\"doi\":\"10.1002/hec.70014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>In the English National Health Service, most patients can use an online platform to send a written request to the practice, in addition to calling or visiting the practice in person. However, there are concerns that the availability of an online access route to primary care can adversely impact healthcare provision for older or lower socioeconomic groups. To examine those concerns, we explore the differential timing of online platforms' implementation between 2019 and 2020 across 289 practices covering over 2.5 million patients in North West London. We find no evidence of an impact of the online access route on age and socioeconomic-related inequity in synchronous interactions in primary care, but observe an increase in all interactions in this setting and in some cases, a small reduction (worst case, no changes) in unplanned hospital care. These findings suggest that having an online access route to primary care can improve the provision of healthcare services, at no detriment to patients from older and lower socioeconomic groups.</p>\",\"PeriodicalId\":12847,\"journal\":{\"name\":\"Health economics\",\"volume\":\"34 10\",\"pages\":\"1943-1962\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hec.70014\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health economics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/hec.70014\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health economics","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hec.70014","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ECONOMICS","Score":null,"Total":0}
Digitalization of Access to Primary Care: Is There an Equity-Efficiency Trade-Off?
In the English National Health Service, most patients can use an online platform to send a written request to the practice, in addition to calling or visiting the practice in person. However, there are concerns that the availability of an online access route to primary care can adversely impact healthcare provision for older or lower socioeconomic groups. To examine those concerns, we explore the differential timing of online platforms' implementation between 2019 and 2020 across 289 practices covering over 2.5 million patients in North West London. We find no evidence of an impact of the online access route on age and socioeconomic-related inequity in synchronous interactions in primary care, but observe an increase in all interactions in this setting and in some cases, a small reduction (worst case, no changes) in unplanned hospital care. These findings suggest that having an online access route to primary care can improve the provision of healthcare services, at no detriment to patients from older and lower socioeconomic groups.
期刊介绍:
This Journal publishes articles on all aspects of health economics: theoretical contributions, empirical studies and analyses of health policy from the economic perspective. Its scope includes the determinants of health and its definition and valuation, as well as the demand for and supply of health care; planning and market mechanisms; micro-economic evaluation of individual procedures and treatments; and evaluation of the performance of health care systems.
Contributions should typically be original and innovative. As a rule, the Journal does not include routine applications of cost-effectiveness analysis, discrete choice experiments and costing analyses.
Editorials are regular features, these should be concise and topical. Occasionally commissioned reviews are published and special issues bring together contributions on a single topic. Health Economics Letters facilitate rapid exchange of views on topical issues. Contributions related to problems in both developed and developing countries are welcome.