Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada
© 2023 CMA Impact Inc. or its licensors..
BACKGROUND: Uptake of virtual care increased substantially during the first year of the COVID-19 pandemic. The aim of this study was to evaluate whether a shift from in-person to virtual visits by primary care physicians was associated with increased use of emergency departments among their enrolled patients.
METHODS: We conducted an observational study of monthly virtual visits and emergency department visits from Apr. 1, 2020, to Mar. 31, 2021, using administrative data from Ontario, Canada. We used multivariable regression analysis to estimate the association between the proportion of a physician's visits that were delivered virtually and the number of emergency department visits among their enrolled patients.
RESULTS: The proportion of virtual visits was higher among female, younger and urban physicians, and the number of emergency department visits was lower among patients of female and urban physicians. In an unadjusted analysis, a 1% increase in a physician's proportion of virtual visits was found to be associated with 11.0 (95% confidence interval [CI] 10.1-11.8) fewer emergency department visits per 1000 rostered patients. After controlling for covariates, we observed no statistically significant change in emergency department visits per 1% increase in the proportion of virtual visits (0.2, 95% CI -0.5 to 0.9).
INTERPRETATION: We did not find evidence that patients substituted emergency department visits in the context of decreased availability of in-person care with their family physician during the first year of the COVID-19 pandemic. Future research should focus on the long-term impact of virtual care on access and quality of patient care.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:195 |
|---|---|
| Enthalten in: |
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne - 195(2023), 3 vom: 23. Jan., Seite E108-E114 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Chami, Nadine [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| Anmerkungen: |
Date Completed 01.02.2023 Date Revised 22.11.2023 published: Print CommentIn: CMAJ. 2023 Mar 14;195(10):E376. - PMID 36918179 Citation Status MEDLINE |
|---|
| doi: |
10.1503/cmaj.212051 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM352010460 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM352010460 | ||
| 003 | DE-627 | ||
| 005 | 20231226052739.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1503/cmaj.212051 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1173.xml |
| 035 | |a (DE-627)NLM352010460 | ||
| 035 | |a (NLM)36690364 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Chami, Nadine |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 01.02.2023 | ||
| 500 | |a Date Revised 22.11.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: CMAJ. 2023 Mar 14;195(10):E376. - PMID 36918179 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 CMA Impact Inc. or its licensors. | ||
| 520 | |a BACKGROUND: Uptake of virtual care increased substantially during the first year of the COVID-19 pandemic. The aim of this study was to evaluate whether a shift from in-person to virtual visits by primary care physicians was associated with increased use of emergency departments among their enrolled patients | ||
| 520 | |a METHODS: We conducted an observational study of monthly virtual visits and emergency department visits from Apr. 1, 2020, to Mar. 31, 2021, using administrative data from Ontario, Canada. We used multivariable regression analysis to estimate the association between the proportion of a physician's visits that were delivered virtually and the number of emergency department visits among their enrolled patients | ||
| 520 | |a RESULTS: The proportion of virtual visits was higher among female, younger and urban physicians, and the number of emergency department visits was lower among patients of female and urban physicians. In an unadjusted analysis, a 1% increase in a physician's proportion of virtual visits was found to be associated with 11.0 (95% confidence interval [CI] 10.1-11.8) fewer emergency department visits per 1000 rostered patients. After controlling for covariates, we observed no statistically significant change in emergency department visits per 1% increase in the proportion of virtual visits (0.2, 95% CI -0.5 to 0.9) | ||
| 520 | |a INTERPRETATION: We did not find evidence that patients substituted emergency department visits in the context of decreased availability of in-person care with their family physician during the first year of the COVID-19 pandemic. Future research should focus on the long-term impact of virtual care on access and quality of patient care | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Shah, Hemant A |e verfasserin |4 aut | |
| 700 | 1 | |a Nastos, Steve |e verfasserin |4 aut | |
| 700 | 1 | |a Shaikh, Shaun |e verfasserin |4 aut | |
| 700 | 1 | |a Tenenbein, Paul K |e verfasserin |4 aut | |
| 700 | 1 | |a Lougheed, Taylor |e verfasserin |4 aut | |
| 700 | 1 | |a Mizdrak, Nikolina |e verfasserin |4 aut | |
| 700 | 1 | |a Conlon, Patrick |e verfasserin |4 aut | |
| 700 | 1 | |a Wright, James G |e verfasserin |4 aut | |
| 700 | 1 | |a Weir, Sharada |e verfasserin |4 aut | |
| 700 | 1 | |a Kantarevic, Jasmin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne |d 1985 |g 195(2023), 3 vom: 23. Jan., Seite E108-E114 |w (DE-627)NLM012612766 |x 1488-2329 |7 nnns |
| 773 | 1 | 8 | |g volume:195 |g year:2023 |g number:3 |g day:23 |g month:01 |g pages:E108-E114 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1503/cmaj.212051 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 195 |j 2023 |e 3 |b 23 |c 01 |h E108-E114 | ||