Cost minimization analysis of digital-first healthcare pathways in primary care

A retrospective, registry-based cost-minimization analysis assessing whether initiating minor acute primary care episodes via a digital-first pathway reduces costs compared to traditional care in a Finnish setting. Of 637,923 encounters, 64,969 eligible episodes were identified in five selected clinical presentations. After propensity score matching (19,697 pairs), mean episode costs were significantly lower in the digital-first pathway (€170.74) than in traditional care (€220.91), reflecting a 22.7% reduction (P < 0.001). Savings varied by clinical presentation, from 10.3% for respiratory infections to 52.5% for gastroenteritis (all P < 0.001). Digital care was associated with lower use of laboratory tests and imaging. Follow-up visits were generally fewer in the digital-first pathway, except for respiratory infections, which showed a slight increase. Sensitivity analyses with 7- and 30-day follow-up windows produced similar results. Overall, this study supports digital-first models as a cost-effective strategy for managing minor acute conditions in primary care.