RT Journal Article
SR Electronic
T1 Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E108
OP E114
DO 10.1503/cmaj.212051
VO 195
IS 3
A1 Nadine Chami
A1 Hemant A. Shah
A1 Steve Nastos
A1 Shaun Shaikh
A1 Paul K. Tenenbein
A1 Taylor Lougheed
A1 Nikolina Mizdrak
A1 Patrick Conlon
A1 James G. Wright
A1 Sharada Weir
A1 Jasmin Kantarevic
YR 2023
UL http://www.cmaj.ca/content/195/3/E108.abstract
AB 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.