Continuity of care and service fulfilment in digital appointments among long-term ill patients

Abstract Background Patients with long-term illnesses often require regular care and monitoring with healthcare professionals, increasingly provided through digital channels. It is essential that these services maintain high standards of care. This study examined the association of digital appointments (via video or chat) with a physician or a nurse on long-term ill patients’ experience of a) continuity of care and b) fulfilled service needs. Methods A total of 10,160 Finnish residents with long-term illnesses necessitating regular care and monitoring (57% female, mean age 57.3, SE .24) responded to a nationwide population survey between September 2022 and March 2023. The Inverse Probability Weighting method was used to correct for bias. Complex samples binary logistic regression was used, and the models were adjusted for patient's age, gender, education and area of residence. Results Of the respondents, 2,131 (25.8%) had used digital appointments with a physician and 1,831 (22.4%) with a nurse at least once in the past year. A digital appointment with a physician (OR 1.30, 95% CI 1.12-1.52) or nurse (OR 1.20, 95% CI 1.20-1.42) was associated with greater odds of meeting the same professional consistently, compared to in-person visits only. However, those using digital nurse appointments had lower odds (OR .77, 95% CI .61-.96) of reporting that their service needs were met than those with in-person nurse visits only. Conclusions Digital appointments have supported continuity of care for patients with long-term illnesses by enabling consistent interactions with the same healthcare professional. However, the lower perceived fulfilment of service needs in nurse-led digital appointments highlights the need for further research to identify and address potential gaps in digital care quality. Ensuring that digital services meet patients’ expectations and maintain high standards of care is essential for their continued integration into healthcare systems. Key messages • Digital appointments with physicians and nurses seem to enhance continuity of care for patients with long-term illnesses, fostering consistent interactions with familiar professionals. • Despite benefits in care continuity, digital nurse appointments seem to associate with lower perceived service fulfilment, indicating a need for further improvement in digital care quality.