Trends and Heterogeneity in the Use of eContacts in Denmark: A Register-Based Study from 2005 to 2019

Patrik Harnisch , Bielefeld University
Yana Vierboom, Princeton University
Ridhi Kashyap, Oxford University
Soghra Bohlourihajjar, None
Kaare Christensen, University of Southern Denmark
Karen Andersen-Ranberg, University of Southern Denmark
Anna Oksuzyan, Bielefeld University

Background: eContacts is an asynchronous communication between patients and general practitioners (GPs), for example via secure emails or mobile applications. Previous studies suggest that eContacts improve efficiency and enhance patient satisfaction. Although quantitative analyses of individual determinants of eContact use are limited, existing research suggests that younger, wealthier, and more educated people are more likely to use eContacts. However, most prior studies are cross-sectional investigations of small and selective samples that do not control for unmeasured confounders and may produce biased estimates. Using nationwide register data in Denmark, this study investigates long-term trends and individual characteristics of eContact use. Methods: Data on eContacts were obtained from the National Health Service Register from 2005 to 2019. The register includes email communication between patients and doctors in municipal clinics, prescription renewals, and short message exchanges via email, encrypted websites, or mobile applications. Mixed-effects regression models were applied to assess associations between eContacts and individual characteristics. Results: Between 2005 and 2019, the average number of eContacts increased across all age groups. Women, highly educated, and high-income individuals showed higher incidence rates while immigrants had substantially lower use across generations. Over time, education-related differences in eContact use narrowed, whereas gender and migration gaps widened. Conclusion: Since 2005, eContact use has increased substantially across all population groups in Denmark, reflecting growing digital engagement in primary care. However, persistent gender and migration-related gaps highlight unequal access and adoption of eContact use. Targeted initiatives promoting digital inclusion are needed to ensure equitable use of eContacts.

See paper

 Presented in Session P8. Demographic Trends, History, Data and Methods