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Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada

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 p ....

United States , United Kingdom , Steve Nastos , James Wright , Taylor Lougheed , Jasmin Kantarevic , Shaun Shaikh , Nikolina Mizdrak , Patrick Conlon , Paul Tenenbein , Hemant Shah , Emergency Department , National Ambulatory Care Reporting System , Ontario Ministry Of Health , Client Agency Enrolment Program , Ontario Medical Association , Ontario Telemedicine Network , Srx Health , United Kingdom National Institute For Health Research , Ontario Health Insurance Plan , Canadian Institute For Health Information , Canadian Institutes Of Health Research , Canadian Institute For Health , Canadian Association For The Study Of Liver , United States National Institute For Health , Canadian Medical Protective Association ,

Trends in prevalence of chronic disease and multimorbidity in Ontario, Canada


Abstract
BACKGROUND: New case-mix tools from the Canadian Institute for Health Information offer a novel way of exploring the prevalence of chronic disease and multimorbidity using diagnostic data. We took a comprehensive approach to determine whether the prevalence of chronic disease and multimorbidity has been rising in Ontario, Canada.
METHODS: In this observational study, we applied case-mix methodology to a population-based cohort. We used 10 years of patient-level data (fiscal years 2008/09 to 2017/18) from multiple care settings to compute the rolling 5-year prevalence of 85 chronic diseases and multimorbidity (i.e., the co-occurrence of 2 or more diagnoses). Diseases were further classified based on type and severity. We report both crude and age- and sex-standardized trends. ....

United States , Mitch Steffler , Farshad Murtada , Jasmin Kantarevic , Jeffrey Hatcher , Ontario Mental Health Reporting System , National Ambulatory Care Reporting System , Ontario Health Insurance Plan , Canadian Institute For Health Information , Tableau Software , Ontario Ministry Of Health , Ontario Medical Association , Canadian Institute , Health Information , Johns Hopkins , Ontario Ministry , Grouping Methodology , Registered Persons Database , Abstract Database , Ambulatory Care Reporting System , Statistics Canada , Tableau Desktop Professional Edition , Ontario Medical , Ontario Cancer Registry , Sharada Weir , Population Grouping Methodology ,