In the SoteDataLab project’s report, we examined digital-clinic and remote contacts in primary health care across public outpatient care, private outpatient care, and occupational health care. According to the report, the share of digital-clinic contacts in public outpatient care was highest among young children, young adults, women, and people in the upper end of the income distribution.

Most wellbeing services counties have already adopted—or are in the process of adopting—a digital clinic or a digital “health and social care centre,” i.e., a digital, often chat-based alternative to in-person primary-care services. The study, based on the AvoHilmo register, included 837,000 residents from five wellbeing services counties that had a public primary-care digital clinic in operation for at least six months during the observation period 4/2023–3/2024 

According to the results, being a customer was associated with sociodemographic factors—such as gender, age, income level, and mother tongue—for both remote contacts and in-person visitsWomen were more often customers than men in all sectors. In public-sector digital-clinic contacts, young children, young adults, and Finnish-speakers were over-represented as customers. In private outpatient care and occupational health care, customers were over-represented from the upper half of the income distribution and among Finnish- and Swedish-speakers; among remote contacts, acting on behalf of children aged 0–9 was prominent.
According to Figure 1 the share of digital-clinic contacts out of all contacts was higher for women than for men in public outpatient care (17% vs. 11%), and the share of remote contacts out of all contacts was higher for women than for men in occupational health care (54% vs. 49%) but not in private outpatient care (21% vs. 22%) By age, the findings do not differ much between sectors: the share of digital-clinic and remote contacts had a clear negative relationship with age, with only those aged 10–19 as an exception to the rule. In public outpatient care, the share of digital-clinic contacts was highest among 20–29-year-olds (25%) and lowest among those over 70 (6–8%). In private outpatient care, the share of remote contacts was particularly high among 0–9-year-olds (up to 35%) and lowest among those over 70 (11–12%).

According to Figure 2 the share of digital-clinic contacts out of all contacts increased by income decile in public outpatient care (12% in the lowest decile vs. 19% in the highest decile), whereas in private outpatient care the share of remote contacts surprisingly decreased slightly as income rose (21% in the lowest decile vs. 19% in the highest decile). A possible explanation is that, among remote contacts, chat visits in particular are cheaper than in-person visits, and the consumption of lower-priced services may be over-represented at the lower end of the income distribution. In occupational health care—where services are free at the point of use—income decile was scarcely related to the share of remote contacts. Note that in Figure 2 the results are shown with age and gender held constant, so these should not be driving the relationships observed in the figure.

Thus, in public outpatient care, the share of digital-clinic contacts out of all contacts was above average among young children, young adults, women, and those at the top of the income distribution—which likely aligns with many prior expectations. The customer profile at public digital clinics was therefore quite different from that of in-person visits in public outpatient care, where, according to the results, older people and those in the lower end of the income distribution were over-represented as customers. 

Can digital services replace more expensive in-person services?

Increases in digital-clinic use are often justified on the grounds that demand for costly in-person services may shift to less expensive remote services. One of our project’s core questions is whether using a digital clinic reduces the number of phone calls or in-person visits—i.e., the pressure on health centres—and, if so, by how much. Or do digital-clinic contacts primarily represent new demand that would not have led to any contact at all if a digital clinic had not been available? We aim to address this and many other questions as the research progresses. 

More information about the study

This blog post is based on the SoteDataLab project report (reference below), which examined health-service use across sectors of primary health care using the AvoHilmo register and Statistics Finland’s FOLK individual-level data. For the public sector, the study covered digital-clinic contacts and in-person visits; for private health care (incl. occupational health), it included remote contacts and in-person visits. When interpreting the results, it is important to note that among the included wellbeing services counties there was considerable variation in how comprehensive the AvoHilmo data on digital-clinic visits were compared with the counties’ own data lakes. 

The research report contains a wide range of analyses and results, as well as a concise literature review, a data description, an assessment of data quality, and assessments of research limitations and possible directions for further study.

Source reference: Haaga, T., Kortelainen, M., Mauno, V., Nokso-Koivisto, O., Saxell, T., Seppä, M., Sääksvuori, L. (2025); Digital clinic and remote services in primary health care and sector-specific attendances in Avohilmo data 4/2023-3/2024; working paper, January 2025, https://osf.io/ey7bn

Authors: Tapio Haaga, Vivi Mauno, What is Kortelainen, Oskari Nokso-Koivisto, Tanja Saxell, Meeri Seppä and Lauri Sääksvuori