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The Effect of 24/7, Digital-First, NHS Primary Care on Acute Hospital Spending: Retrospective Observational Analysis
- Source :
- Journal of Medical Internet Research
- Publication Year :
- 2020
-
Abstract
- Background Digital health has the potential to revolutionize health care by improving accessibility, patient experience, outcomes, productivity, safety, and cost efficiency. In England, the NHS (National Health Service) Long Term Plan promised the right to access digital-first primary care by March 31, 2024. However, there are few global, fully digital-first providers and limited research into their effects on cost from a health system perspective. Objective The aim of this study was to evaluate the impact of highly accessible, digital-first primary care on acute hospital spending. Methods A retrospective, observational analysis compared acute hospital spending on patients registered to a 24/7, digital-first model of NHS primary care with that on patients registered to all other practices in North West London Collaboration of Clinical Commissioning Groups. Acute hospital spending data per practice were obtained under a freedom of information request. Three versions of NHS techniques designed to fairly allocate funding according to need were used to standardize or “weight” the practice populations; hence, there are 3 results for each year. The weighting adjusted the populations for characteristics that impact health care spending, such as age, sex, and deprivation. The total spending was divided by the number of standardized or weighted patients to give the spending per weighted patient, which was used to compare the 2 groups in the NHS financial years (FY) 2018-2019 (FY18/19) and 2019-2020 (FY19/20). FY18/19 costs were adjusted for inflation, so they were comparable with the values of FY19/20. Results The NHS spending on acute hospital care for 2.43 million and 2.54 million people (FY18/19 and FY19/20) across 358 practices and 49 primary care networks was £1.6 billion and £1.65 billion (a currency exchange rate of £1=US $1.38 is applicable), respectively. The spending on acute care per weighted patient for Babylon GP at Hand members was 12%, 31%, and 54% (£93, P=.047; £223, P Conclusions Patients with access to 24/7, digital-first primary care incurred significantly lower acute hospital costs.
- Subjects :
- medicine.medical_specialty
Telemedicine
020205 medical informatics
Population
digital care
digital health
retrospective
finance
Health Informatics
02 engineering and technology
family practice
State Medicine
03 medical and health sciences
0302 clinical medicine
cost analysis
virtual care
Acute care
Patient experience
Health care
cost
0202 electrical engineering, electronic engineering, information engineering
Medicine
Humans
030212 general & internal medicine
observational
hospital
education
Retrospective Studies
general practice
education.field_of_study
Original Paper
Primary Health Care
business.industry
Health services research
cohort
economics
Digital health
Hospitals
health services research
Family medicine
Observational study
telemedicine
digital technology
business
Delivery of Health Care
Subjects
Details
- ISSN :
- 14388871
- Volume :
- 23
- Issue :
- 7
- Database :
- OpenAIRE
- Journal :
- Journal of medical Internet research
- Accession number :
- edsair.doi.dedup.....8c1fc7ba94eb026ec36417322fd584fd