Socioeconomic, medical and demographic characteristics of early adopters of digital primary care

Abstract

In this paper, we investigated which socioeconomic and demographic groups first adopted digital primary care video consultations when they became accessible to the entire population in Sweden. We analysed data on all patients (378,000) who had a consultation with the largest provider of digital healthcare in Sweden - Kry - in the first years of national availability of the service, 2016-2018. We studied their income, education, demographics, and diagnosis backgrounds using matched registry data. Moreover, to compare users and non-users of digital primary care, we used data on all physical primary care users in one Swedish region: Skåne. We found that this digital primary care was first used by young and higher-income adults, but not far from half of adult users had incomes below the national median. Digital care patients were more educated than the general population, reflecting that urban inhabitants were more likely than rural inhabitants to be users. First-generation immigrants were less represented among digital care users than in the population. However, second-generation immigrants with two foreign parents were slightly over-represented. The prevalence of some chronic diseases in pre-digital secondary (specialist and hospital) healthcare data among digital care users was similar to the population adjusted for age. Studying all physical primary care users in Skåne region, young digital care users had more primary care diagnoses and previous in-person primary care appointments than non-users, while the pattern was reversed for older users. When digital primary care became nationally available, younger, urban and more educated patients were the first to adopt the new technology. Regarding medical history, young users of digital care had a higher previous disease burden than young non-users, suggesting that these digital services were first adopted by young people with high primary care needs.