Kaisa Kujansivu, Elina Tolvanen, Tapio Haaga, Lauri Sääksvuori, Mika Kortelainen, Oskari Nokso-Koivisto, Tuomas Koskela
Abstract
Introduction
Chat-based digital clinics have become an increasingly important gateway to primary healthcare in many countries. This exploratory study describes the socio-demographic characteristics of digital clinic users, examines patterns of digital clinic use among potentially vulnerable population groups, and compares the medical reasons for chat-based digital clinic contacts with those of traditional primary care.
Material and methods
We conducted an observational register-based study using nationwide data covering digital and traditional contacts to public and private primary care clinics in Finland from January 2022 to February 2025. Using a rich linked dataset, we examined several potentially vulnerable socioeconomic subgroups, including individuals aged 80 and above, those with multimorbidity, the unemployed, and members of the lowest income quintile. The study population comprised 1,599,588 individuals residing in eight wellbeing services counties in Finland.
Results
Public digital clinic users appeared to be younger, more often women, and more often live in urban areas, and have a lower prevalence of chronic illnesses compared with users of traditional public primary care. Potentially vulnerable patient groups also used digital services, although they used traditional services more. Medical reasons for digital clinic contacts were often relatively simple, but individuals with chronic illnesses also used digital services to address their care needs.
Discussion
We observed differences in the characteristics of users of digital and traditional primary healthcare services. We generated hypotheses for future research on equity in digital healthcare access. Further research is needed to evaluate whether improving access to digital services for vulnerable groups could support health equity.
KEY POINTS
- Differences were observed between users of digital and traditional primary healthcare services.
- Potentially vulnerable patient groups also used digital services, although traditional services appeared to remain more commonly used among these groups.
- A higher number of digital clinic contacts was observed among individuals with greater previous healthcare use
- Medical reasons for digital clinic contacts were often relatively simple, although individuals with chronic illnesses also used digital services to address their care needs.
- The findings highlight the need for further research on how digital clinics can be developed to support accessibility and equity across population groups.
- Future research should examine how digital tools may support continuity of care in primary healthcare.