Observational studyJournal of medical Internet research2021
The Effect of 24/7, Digital-First, NHS Primary Care on Acute Hospital Spending: Retrospective Observational Analysis.
Observational study in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Impact of virtual appointments on referral-to-appointment times for type 2 diabetes patients in Northwest London.npj health systems · 2026Article
- Accessibility to Primary Care Services for Immigrants Experiencing Homelessness in England: A Qualitative Exploratory Study.International journal of environmental research and public health · 2026Article
- Impact of Telemedicine on Health Expenditures During the COVID-19 Pandemic in Japan: Quasi-Experimental Study.Journal of medical Internet research · 2025Article
- Technology readiness among UK-based cognitively unaffected older adults during the COVID-19 pandemic: potential implications for decentralised alzheimer's disease prevention trials.BMC geriatrics · 2025Observational
- Differences in Use of a Patient Portal Across Sociodemographic Groups: Observational Study of the NHS App in England.Journal of medical Internet research · 2024Observational
- Patient satisfaction and digital health in primary health care: a scoping review protocol.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDigital 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.
objectiveThe aim of this study was to evaluate the impact of highly accessible, digital-first primary care on acute hospital spending.
methodsA 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.
resultsThe 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<.001; and £389, P<.001) lower than the regional average in FY18/19 for the 3 weighting methodologies used. In FY19/20, it was 15%, 35%, and 51% (£114, P=.006; £246, P<.001; and £362, P<.001) lower. This amounted to lower costs for the Babylon GP at Hand population of £1.37, £4.40 million, and £11.6 million, respectively, in FY18/19; and £3.26 million, £9.54 million, and £18.8 million, respectively, in FY19/20.
conclusionsPatients with access to 24/7, digital-first primary care incurred significantly lower acute hospital costs.
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