Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jan 13, 2023
Date Accepted: Jun 5, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Impact of Mobile Health and Fitness Application Adoption on Hospital Visits: Difference-in-Differences Analysis
ABSTRACT
Background:
Overcrowding in public hospitals is a common issue in many countries, which leads to significant adverse impacts, such as insufficient access to medical services and patient dissatisfaction. Mobile health and fitness applications (apps) are regarded as a new way to promote users’ health behaviors and produce health benefits, thereby reducing hospital visits. However, some doubts about their effectiveness have also been raised.
Objective:
This study estimates the causal effect of the adoption of health and fitness apps on hospital visits by exploiting the staggered timing of adoption. We also investigate how the effect varies with users’ socioeconomic status and digital literacy.
Methods:
A rich and unique dataset of mobile phone users in China is used. The sample contains app usage and geolocation data of 267651 unique users in 2019. Difference-in-differences (DiD) and difference-in-difference-in-differences (DDD) specifications with fixed effects are conducted to estimate the causal effect. The interactions of the post-adoption indicator with users’ consumption levels, city tiers and digital literacy are calculated to analyze the heterogeneity.
Results:
The results of the preferred DDD model show a significant decrease in hospital visits after adoption of the health and fitness app. App adoption leads to a 5.8% (P<.001), a 13.1% (P<.001) and an 18.4% reduction (P<.001) in hospital visits 1, 2, and 3 months after the adoption, respectively. In addition, moderation analysis shows that the effect is greater for users of high consumption levels, in high tier cities, or with high digital literacy.
Conclusions:
This study estimates the causal effect of the adoption of health and fitness apps on hospital visits. The results show that the app adoption can reduce users’ hospital visits. The effects exhibit different patterns for different group of users. The findings provide useful insights for multiple stakeholders in the healthcare.
Citation
