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Evaluating the effect of digital primary care on antibiotic prescription: Evidence using Swedish register data
Department of Clinical Sciences, Lund University, Lund, Sweden.
Department of Clinical Sciences, Lund University, Lund, Sweden.
Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Region Jönköping's County, Futurum, Sweden.ORCID iD: 0000-0002-2843-2169
Department of Clinical Sciences, Lund University, Lund, Sweden.
2023 (English)In: Digital Health, E-ISSN 2055-2076, Vol. 9, no January-DecemberArticle in journal (Refereed) Published
Abstract [en]

Background: The growing use of digital primary care consultations has led to concerns about resource use, equity and quality. One of these is how it affects antibiotic prescription. Differences in ease of access for patients and available diagnostic information for the prescribing physicians are reasons to believe prescription rates may be affected. Objectives: We estimated differences in antibiotic prescription between traditional office-based and digital contacts, if these differences varied between groups of diagnoses depending on the availability of information for the prescribing physician, and if differences were associated with socio-demographic patient characteristics. Methods: Using individual level register data for a sample of patients diagnosed with an infection over a two-year period, we estimated differences in prescription between the two types of contacts and applied propensity score techniques to mitigate possible problems with treatment selection bias. Results: The share of antibiotic prescription was 28 (95% CI 27–30, p < 0.001) to 33 (95% CI 29–36, p < 0.001) percentage points lower among digital contacts as compared to office-based contacts. For urinary tract infections, the differences in prescription rates between the two contact types were smaller (34 to 41 percentage points difference) than for throat and skin infections (50 to 60 percentage points difference). For women, rural, older, and people born outside Sweden, digital contacts were associated with higher prescription rates. Conclusions: Antibiotic prescription rates were significantly lower for digital contacts compared with office-based contacts. The findings suggest that digital primary care may be an effective alternative to in-person visits without undue consequences for antibiotic prescription levels, although to varying degree depending on diagnosis.

Place, publisher, year, edition, pages
Sage Publications, 2023. Vol. 9, no January-December
Keywords [en]
antibiotics prescriptions, digital contacts, Primary care, socioeconomic factors, Sweden
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-59966DOI: 10.1177/20552076231156213ISI: 000934413400001Scopus ID: 2-s2.0-85148438602Local ID: GOA;;864206OAI: oai:DiVA.org:hj-59966DiVA, id: diva2:1741819
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-00093Available from: 2023-03-07 Created: 2023-03-07 Last updated: 2024-01-17Bibliographically approved

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