The aim of this study is to examine whether patients are subjected to ethnic discrimination when seeking medical care within the digital Swedish primary health care service: 1177-direct. In doing so, we aim to identify and statistically control for other major pathways through which treatment differences may arise and which do not constitute direct discrimination, e.g., ethnic group differences in comorbidity. The stored data from the "1177-direct" digital platform enable rigorous examination of discrimination of patients with different ethnic backgrounds that are matched in many respects (e.g., reported symptoms, comorbidity, socioeconomic status, gender). Discrimination as manifested by ethnic differences in health care professionals' patient-centered communication (from the digital chat) and medical treatment will be probed for. By pinpointing the mechanisms underlying unequal care (e.g., discrimination), the results should be of relevance to future interventions aimed at combating inequalities in health care.

Inclusion Criteria:

• patients being 18 years or older and appearing in the "1177-direct" data base

Exclusion Criteria:

-

The base population consists of patient "visits" in the digital "1177 direct" health care service platform. Health care professionals who digitally interacted with these patients are also included in the study population. The study population comes from Region Kalmar county and includes all patients 18 years or older who appear in the "1177 direct" data base.

Individual participant data cannot be shared feely and made publicly because it may contain sensitive personal information and is located on Statistics Sweden's secure server: MONA. Researchers who would like to reproduce our results need to obtain the necessary approvals and be granted access to the registry and MONA. If approvals are obtained, we will share:

Study Protocol Statistical Analysis Plan (SAP) Analytic Code