Defying Distance? The Provision of Medical Services in the Digital Age

Digital platforms reduce geographic frictions, enabling better matching between service providers and users. I quantify reallocation gains in Swedish online health care, using nationwide time-conditional random assignment between patients and physicians. Matching high-risk patients with doctors effective at reducing Emergency Room visits lowers such visits by 4.4 percent (SE 1.3); reallocations also reduce Counter-Guideline antibiotics by 3.1 percent (1.4). I find limited trade-offs in matching; horizontal differentiation among doctors and varied patient needs allow improvement in multiple outcomes simultaneously. Efficiency-enhancing reallocations also affect equity. The findings highlight the potential for care reorganization aligning provider heterogeneity with patient needs when geographic constraints are lifted. (JEL C78, H51, I11, I13, I14, I18)

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Publication Details

Journal
American Economic Review
Published
2026-08-28
DOI
https://doi.org/10.1257/aer.20240756
Primary Topic
Healthcare Policy and Management
Type
article
Field-Weighted Citation Impact
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article

Defying Distance? The Provision of Medical Services in the Digital Age

Amanda Dahlstrand
American Economic Review
Healthcare Policy and Management
article

Defying Distance? The Provision of Medical Services in the Digital Age

Amanda Dahlstrand
article en

Abstract

Digital platforms reduce geographic frictions, enabling better matching between service providers and users. I quantify reallocation gains in Swedish online health care, using nationwide time-conditional random assignment between patients and physicians. Matching high-risk patients with doctors effective at reducing Emergency Room visits lowers such visits by 4.4 percent (SE 1.3); reallocations also reduce Counter-Guideline antibiotics by 3.1 percent (1.4). I find limited trade-offs in matching; horizontal differentiation among doctors and varied patient needs allow improvement in multiple outcomes simultaneously. Efficiency-enhancing reallocations also affect equity. The findings highlight the potential for care reorganization aligning provider heterogeneity with patient needs when geographic constraints are lifted. (JEL C78, H51, I11, I13, I14, I18)

American Economic ReviewVol. 116(9)
University of Zurich (CH)
Partnerships for the goals
Openalex Percentile: Top 86%
Healthcare Policy and Management
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