A retrospective, registry-based cost-minimization analysis assessed whether initiating acute primary care episodes via a digital-first pathway reduces costs compared to traditional care in a Finnish setting (Harjun Terveys). Of 637,923 encounters, 64,969 eligible acute episodes were identified. After propensity score matching (19,697 pairs), mean episode costs were significantly lower in the digital pathway (€170.74) than in traditional care (€220.91), reflecting a 22.7% reduction (P<.001). Savings varied by clinical presentation, from 10.3% for respiratory infections to 52.5% for gastroenteritis (all P<.001). Digital care was associated with lower use of laboratory tests and imaging. Follow-up visits were generally fewer in the digital group, except for respiratory infections, which showed a slight increase. Sensitivity analyses with 7- and 30-day follow-up windows confirmed the findings. Overall, this study supports digital-first models as a cost-effective strategy for managing acute conditions in primary care, with potential to reduce unnecessary resource use without compromising continuity of care.

The authors declare the following competing interests: All authors are employed by Mehiläinen, the healthcare provider that developed and operates the digital clinic evaluated in this study. Some authors hold personal financial interests in Mehiläinen. The study was funded by Mehiläinen, and the leadership of Harjun terveys provided institutional support throughout the research process.

This study was funded by the service provider in question.

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:

Päijät Häme Wellbeing Services County Research Permit, Case Number HA/85/07.01.04.05/2024 Ethical approval waived; retrospective registry-based study.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

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

Yes

All data produced during this study are included in this published article or supplementary attachments. Due to privacy regulations, patient-level data cannot be shared.