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

Author

Listed:
  • 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)

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.

Suggested Citation

  • Hessam Bavafa & Lorin M. Hitt & Christian Terwiesch, 2018. "The Impact of E-Visits on Visit Frequencies and Patient Health: Evidence from Primary Care," Management Science, INFORMS, vol. 64(12), pages 5461-5480, December.
    • Handle: RePEc:inm:ormnsc:v:64:y:2018:i:12:p:5461-5480
    DOI: 10.1287/mnsc.2017.2900
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