Telehealth in Primary Care: Demographic and Health Characteristics of Users and Non-Users in Sweden (n=73,486)

Pär Eriksson, Maria Rendjelovic, Hans Thulesius, Tora Hammar, Stefan Lagrosen, Evalill Nilsson

Keywords: Telehealth, Primary healthcare, Socioeconomic status, Healthcare utilization, Resource utilization

Background:

Telehealth in primary healthcare has the potential to address several key challenges in healthcare delivery. However, its success largely depends on which patient groups adopt this technology. Understanding the differences between users and non-users of telehealth services is crucial for tailoring implementation strategies.

Research questions:

This study aimed to investigate the differences between users and non-users of telehealth integrated into traditional office-based primary healthcare in two regions of southeastern Sweden.

Method:

A quantitative registry-based population study was conducted across two regions in Sweden, involving 73,486 individuals. The study compared telehealth users and non-users across sex, age, socioeconomic status, morbidity, and healthcare seeking behavior. Data were collected over two study periods: from September 2019 to February 2022. A reference period from September 2016 to August 2019 was used to assess healthcare seeking behavior.

Results:

Telehealth users were more likely to be women under the age of 60, with higher morbidity levels compared to non-users (p<0.001). However, there were no statistically significant differences between the two groups in terms of socioeconomic status, measured by the Care Need Index. Healthcare seeking behavior, as indicated by health record entries, was higher among users compared to non-users.

Conclusions:

Our findings suggest that telehealth users are more likely to be women and younger than 60 years, with higher healthcare needs. Despite this, no significant differences in socioeconomic status were found between users and non-users. These findings highlight that telehealth adoption in primary care may not be influenced by socioeconomic status, and users tend to have higher healthcare utilization and morbidity.

Points for discussion:

How can we ensure broader adoption of telehealth among older adults, who are currently underrepresented?

What strategies can be employed to attract individuals with lower socioeconomic status to use telehealth services?

How can healthcare systems effectively integrate telehealth without exacerbating existing health disparities?

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