Background: Primary health care clinics use several different types of consultations, including on-site visits and remote contacts to see patients. However, it is not clear what factors determine the choice of consultation type taking into consideration the full spectrum of options. Objectives: This study uses national register data from Sweden on all primary care consultations in the years 2019 to 2022 (N = 15,3-19,5 million) to model four types of consultations: office visits, digital contacts (text messages or video), home visits, and telephone/letter contacts. Methods: The modelling of consultation type takes the cross-sectional, panel, and multilevel structure of the data into consideration fitting multinomial logistic models while controlling for patient, clinic, and context factors. Results: In the current context, the choice of consultation type is determined by both patient (age, socioeconomic status, diagnosis) and clinic (public or private) factors, as well as context factors (reimbursement mechanism). From a policy perspective, only weak evidence is found to suggest that paying clinics for digital contacts increases those types of consultations. Conclusions: The findings may inform the development and implementation of policies and regulations to improve the delivery of primary health care in similar contexts.

The authors have declared no competing interest.

This study was funded by the Swedish Research Council.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study received ethical approval from the Swedish Ethics Review Authority (EPM) on 21 September 2022 (Dnr. 2022-03964-01).

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Yes

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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All data produced in the present study are available upon reasonable request to the authors.