Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization
Abstract Background Social and geographical inequity in access to primary healthcare is an ongoing concern in Sweden. Digital care can potentially decrease geographical inequity. This study aimed to evaluate how urbanicity affects the utilization of a public digital primary healthcare service - PHC...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12939-024-02159-7 |
| _version_ | 1797199551558320128 |
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| author | Jon Eriksson Susanna Calling Ulf Jakobsson Moa Wolff Beata Borgström Bolmsjö Veronica Milos Nymberg |
| author_facet | Jon Eriksson Susanna Calling Ulf Jakobsson Moa Wolff Beata Borgström Bolmsjö Veronica Milos Nymberg |
| author_sort | Jon Eriksson |
| collection | DOAJ |
| description | Abstract Background Social and geographical inequity in access to primary healthcare is an ongoing concern in Sweden. Digital care can potentially decrease geographical inequity. This study aimed to evaluate how urbanicity affects the utilization of a public digital primary healthcare service - PHC Online. Methods We performed an ecological cross-sectional study of 4,482 PHC Online visits grouped by 83 public primary healthcare centers. Multiple linear regression analysis was performed with PHC Online visits per 1,000 registered patients as the dependent variable and urbanicity (municipalities grouped by number of inhabitants), socioeconomic status (Care Need Index), and morbidity (Adjusted Clinical Groups) per primary healthcare center as independent variables. Results Utilization of PHC Online was more common among those of a younger age (median 32 years) and among women (65%). Urbanicity did not affect utilization. Lower socioeconomic status and higher morbidity had negative effects on utilization (B -3.289, p = 0.001, B -7.728, p = 0.045). Conclusions Geographical differences based on urbanicity do not seem to affect the utilization of PHC Online. Further studies are needed to clarify a possible association to geographical barriers in access to primary healthcare, specifically accounting for factors associated with urbanicity and distance to physical clinics, and how age and sex affect such an association. Lower utilization of PHC Online in low socioeconomic status and high morbidity populations raises questions on the effect of digital primary care on equitable access to primary healthcare. |
| first_indexed | 2024-04-24T07:17:33Z |
| format | Article |
| id | doaj.art-817d69281520424091a8e584dc7f06b8 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-04-24T07:17:33Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-817d69281520424091a8e584dc7f06b82024-04-21T11:12:25ZengBMCInternational Journal for Equity in Health1475-92762024-04-012311810.1186/s12939-024-02159-7Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilizationJon Eriksson0Susanna Calling1Ulf Jakobsson2Moa Wolff3Beata Borgström Bolmsjö4Veronica Milos Nymberg5Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund UniversityAbstract Background Social and geographical inequity in access to primary healthcare is an ongoing concern in Sweden. Digital care can potentially decrease geographical inequity. This study aimed to evaluate how urbanicity affects the utilization of a public digital primary healthcare service - PHC Online. Methods We performed an ecological cross-sectional study of 4,482 PHC Online visits grouped by 83 public primary healthcare centers. Multiple linear regression analysis was performed with PHC Online visits per 1,000 registered patients as the dependent variable and urbanicity (municipalities grouped by number of inhabitants), socioeconomic status (Care Need Index), and morbidity (Adjusted Clinical Groups) per primary healthcare center as independent variables. Results Utilization of PHC Online was more common among those of a younger age (median 32 years) and among women (65%). Urbanicity did not affect utilization. Lower socioeconomic status and higher morbidity had negative effects on utilization (B -3.289, p = 0.001, B -7.728, p = 0.045). Conclusions Geographical differences based on urbanicity do not seem to affect the utilization of PHC Online. Further studies are needed to clarify a possible association to geographical barriers in access to primary healthcare, specifically accounting for factors associated with urbanicity and distance to physical clinics, and how age and sex affect such an association. Lower utilization of PHC Online in low socioeconomic status and high morbidity populations raises questions on the effect of digital primary care on equitable access to primary healthcare.https://doi.org/10.1186/s12939-024-02159-7Digital healthcareHealth equityHealthcare utilizationUrbanicitySocioeconomic status |
| spellingShingle | Jon Eriksson Susanna Calling Ulf Jakobsson Moa Wolff Beata Borgström Bolmsjö Veronica Milos Nymberg Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization International Journal for Equity in Health Digital healthcare Health equity Healthcare utilization Urbanicity Socioeconomic status |
| title | Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization |
| title_full | Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization |
| title_fullStr | Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization |
| title_full_unstemmed | Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization |
| title_short | Inequity in access to digital public primary healthcare in Sweden: a cross-sectional study of the effects of urbanicity and socioeconomic status on utilization |
| title_sort | inequity in access to digital public primary healthcare in sweden a cross sectional study of the effects of urbanicity and socioeconomic status on utilization |
| topic | Digital healthcare Health equity Healthcare utilization Urbanicity Socioeconomic status |
| url | https://doi.org/10.1186/s12939-024-02159-7 |
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