Characterizing the use of virtual care in primary care settings during the COVID-19 pandemic: a retrospective cohort study

BMC Primary Care

Research

Gayle Halas¹  Lisa LaBine¹  Daniel Shenoda¹  Alanna Baldwin¹  Alexander Singer¹  Jose Francois¹  Leanne Kosowan¹  Alan Katz²  Elissa M Abrams³  Sarah Kirby⁴  Siddhesh Talpade⁵  Sabrina T. Wong⁶ 

[1] Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, D009-780 Bannatyne Ave, R3T2N2, Winnipeg, MB, Canada;Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, D009-780 Bannatyne Ave, R3T2N2, Winnipeg, MB, Canada;Departments of Community Health Science and Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada;Manitoba Centre for Health Policy, Winnipeg, MB, Canada;Department of Pediatrics, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada;Department of Pediatrics, Division of Allergy and Immunology, University of British Columbia, Vancouver, BC, Canada;George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada;Planning and Knowledge Management, Manitoba Health and Seniors Care, Winnipeg, MB, Canada;School of Nursing and Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada;

关键词: Primary health care;    COVID-19;    Telemedicine;    Virtual care;    Medical informatics;    Health care quality, access, evaluation;   

DOI  :  10.1186/s12875-022-01890-w

 received in 2022-01-19, accepted in 2022-10-26,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundIn March 2020, Canada implemented restrictions to curb viral transmission of COVID-19, which resulted in abrupt disruptions to conventional (in-person) clinical care. To retain continuity of care the delivery of primary care services shifted to virtual care. This study examined the nature of virtual visits, characterizing the use and users of virtual care in primary care settings from March 14/20 to June 30/20 of the COVID-19 pandemic. MethodsRetrospective cohort study of primary care providers in Manitoba, Canada that participate in the Manitoba Primary Care Research Network (MaPCReN) and offered ≥ 1 virtual care visit between 03/14/20 and 06/30/20 representing 142,616 patients. Tariff codes from billing records determined the visit type (clinic visit, virtual care). Between 03/14/20, and 06/30/20, we assessed each visit for a follow-up visit between the same patient and provider for the same diagnosis code. Patient (sex, age, comorbidities, visit frequency, prescriptions) and provider (sex, age, clinic location, provider type, remuneration, country of graduation, return visit rate) characteristics describe the study population by visit type. Generalized estimating equation models describe factors associated with virtual care. ResultsThere were 146,372 visits provided by 154 primary care providers between 03/14/20 and 06/30/20, of which 33.6% were virtual care. Female patients (OR 1.16, CI 1.09–1.22), patients with ≥ 3 comorbidities (OR 1.71, CI 1.44–2.02), and patients with ≥ 10 prescriptions (OR 2.71, 2.2–1.53) had higher odds of receiving at least one virtual care visit compared to male patients, patients with no comorbidities and patients with no prescriptions. There was no significant difference between the number of follow-up visits that were provided as a clinic visit compared to a virtual care visit (8.7% vs. 5.8%) (p = 0.6496).ConclusionEarly in the pandemic restrictions, approximately one-third of visits were virtual. Virtual care was utilized by patients with more comorbidities and prescriptions, suggesting that patients with chronic disease requiring ongoing care utilized virtual care. Virtual care as a primary care visit type continues to evolve. Ongoing provision of virtual care can enhance quality, patient-centered care moving forward.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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Fig. 6