Virtual care in Ontario community health centres: a cross-sectional study to understand changes in care delivery.
COVID-19
primary health care
telemedicine
virtual care
Journal
BJGP open
ISSN: 2398-3795
Titre abrégé: BJGP Open
Pays: England
ID NLM: 101713531
Informations de publication
Date de publication:
Sep 2022
Sep 2022
Historique:
received:
16
12
2021
revised:
16
12
2021
accepted:
22
02
2022
pubmed:
2
3
2022
medline:
2
3
2022
entrez:
1
3
2022
Statut:
epublish
Résumé
There has been a large-scale adoption of virtual delivery of primary care as a result of the COVID-19 pandemic. In this descriptive study, an equity lens is used to explore the impact of transitioning to greater use of virtual care in community health centres (CHCs) across Ontario, Canada. A cross-sectional survey was administered and electronic medical record (EMR) data were extracted from 36 CHCs. The survey captured CHCs' experiences with the increased adoption of virtual care. A longitudinal analysis of the EMR data was conducted to evaluate changes in health service delivery. EMR data were extracted monthly for a period of time before the pandemic (April 2019-February 2020) and during (April 2020-February 2021). In comparison with the pre-pandemic period, CHCs experienced a moderate decline in visits made (11%), patients seen (9%), issues addressed (9%), and services provided (15%). During the pandemic period, an average of 54% of visits were conducted virtually, with telephone as the leading virtual modality (96%). Drops in service types ranged from 28%-82%. The distribution of virtual modalities varied according to the provider type. Access to in-person and virtual care did not vary across patient characteristics. The results demonstrate a large shift towards virtual delivery while maintaining in-person care. No meaningful differences were found in virtual versus in-person care related to patient characteristics or rurality of centres. Future studies are needed to explore how to best select the appropriate modality for patients and service types.
Sections du résumé
BACKGROUND
BACKGROUND
There has been a large-scale adoption of virtual delivery of primary care as a result of the COVID-19 pandemic.
AIM
OBJECTIVE
In this descriptive study, an equity lens is used to explore the impact of transitioning to greater use of virtual care in community health centres (CHCs) across Ontario, Canada.
DESIGN & SETTING
METHODS
A cross-sectional survey was administered and electronic medical record (EMR) data were extracted from 36 CHCs.
METHOD
METHODS
The survey captured CHCs' experiences with the increased adoption of virtual care. A longitudinal analysis of the EMR data was conducted to evaluate changes in health service delivery. EMR data were extracted monthly for a period of time before the pandemic (April 2019-February 2020) and during (April 2020-February 2021).
RESULTS
RESULTS
In comparison with the pre-pandemic period, CHCs experienced a moderate decline in visits made (11%), patients seen (9%), issues addressed (9%), and services provided (15%). During the pandemic period, an average of 54% of visits were conducted virtually, with telephone as the leading virtual modality (96%). Drops in service types ranged from 28%-82%. The distribution of virtual modalities varied according to the provider type. Access to in-person and virtual care did not vary across patient characteristics.
CONCLUSION
CONCLUSIONS
The results demonstrate a large shift towards virtual delivery while maintaining in-person care. No meaningful differences were found in virtual versus in-person care related to patient characteristics or rurality of centres. Future studies are needed to explore how to best select the appropriate modality for patients and service types.
Identifiants
pubmed: 35228196
pii: BJGPO.2021.0239
doi: 10.3399/BJGPO.2021.0239
pmc: PMC9680745
pii:
doi:
Types de publication
Journal Article
Langues
eng
Informations de copyright
Copyright © 2022, The Authors.
Références
JMIR Hum Factors. 2021 Jul 9;8(3):e29690
pubmed: 34184994
Healthc Policy. 2014;10(1):14-29
pubmed: 25410693
J Gen Intern Med. 2021 Jan;36(1):256-258
pubmed: 33105000
J Med Internet Res. 2021 Jan 21;23(1):e20621
pubmed: 33326410
J Med Internet Res. 2020 Jun 16;22(6):e19284
pubmed: 32501804
Lancet Glob Health. 2020 Nov;8(11):e1364-e1365
pubmed: 32791119
CMAJ. 2021 Feb 8;193(6):E200-E210
pubmed: 33558406
Lancet. 2020 Apr 11;395(10231):1180-1181
pubmed: 32278374
J Integr Care (Brighton). 2018;26(3):231-241
pubmed: 30166944
JMIR Form Res. 2021 Apr 5;5(4):e23233
pubmed: 33739931
J Med Internet Res. 2020 Jun 2;22(6):e19361
pubmed: 32452816
J Am Acad Orthop Surg. 2020 Jun 1;28(11):e469-e476
pubmed: 32301818
J Med Internet Res. 2021 Feb 18;23(2):e23795
pubmed: 33539307
Healthc Q. 2020 Oct;23(3):29-33
pubmed: 33243363
Clin Gastroenterol Hepatol. 2020 Jul;18(8):1688-1690
pubmed: 32315781
BMJ Open. 2021 Mar 16;11(3):e045343
pubmed: 33727273