The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care

Hessam Bavafa (), Lorin M. Hitt () and Christian Terwiesch ()
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Hessam Bavafa: Wisconsin School of Business, University of Wisconsin–Madison, Madison, Wisconsin 53706
Lorin M. Hitt: The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania 19104
Christian Terwiesch: The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania 19104; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104

Management Science, 2018, vol. 64, issue 12, 5461-5480

Abstract: Secure messaging, or “e-visits,” between patients and providers has sharply increased in recent years, and many hope they will help improve healthcare quality, while increasing provider capacity. Using a panel data set from a large healthcare system in the United States, we find that e-visits trigger about 6% more office visits, with mixed results on phone visits and patient health. These additional visits come at the sacrifice of new patients: physicians accept 15% fewer new patients each month following e-visit adoption. Our data set on nearly 100,000 patients spans from 2008 to 2013, which includes the rollout and diffusion of e-visits in the health system we study. Identification comes from difference-in-differences estimates leveraging variation in the timing of e-visit adoption by both patients and providers. We conduct several robustness checks, including matching analyses and an instrumental variable analysis to account for possible time-varying characteristics among patient e-visit adopters.

Keywords: healthcare operations; service operations; primary care; e-visits; patient portals; empirical (search for similar items in EconPapers)
Date: 2018
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Citations: View citations in EconPapers (34)

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