Digitalization of access to primary care: is there an equity-efficiency trade-off?
Author(s)
Rodrigues, Daniela
Kreif, Noemi
Darzi, Ara
Barahona, Mauricio
Mayer, Erik
Type
Journal Article
Abstract
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.
Date Issued
2025-10-01
Date Acceptance
2025-06-27
Citation
Health Economics, 2025, 34 (10), pp.1943-1962
ISSN
1057-9230
Publisher
Wiley
Start Page
1943
End Page
1962
Journal / Book Title
Health Economics
Volume
34
Issue
10
Copyright Statement
© 2025 The Author(s). Health Economics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1002/hec.70014
Subjects
access | efficiency | equity | primary care | technology | utilization JEL Classification: C10
D63
I10
I14
I18
O33
Publication Status
Published
Date Publish Online
2025-07-17