Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada.
Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada.
复制标题
DOI：
10.1503/cmaj.202303
复制
发表时间：
2021-02-08
期刊：
影响因子：
--
通讯作者：
Kiran T
中科院分区：
文献类型：
--
作者：
Glazier RH;Green ME;Wu FC;Frymire E;Kopp A;Kiran T
在全球范围内，2019年冠状病毒病（COVID-19）大流行导致初级保健发生了巨大变化。我们的目的是了解在加拿大安大略省大流行的最初几个月里，办公室和虚拟初级保健的变化程度，以及患者和医生的变化程度。这项基于人群的研究将2020年1月1日至7月28日的综合、关联的初级保健医生账单数据与2019年同期进行了比较。我们确定安大略省居民在研究期间至少有一次办公室或虚拟（电话或视频）访问。根据不同的患者和医生特征，我们比较了COVID-19之前的总医生就诊、办公室就诊和虚拟就诊趋势与大流行相关的公共卫生措施改变护理提供后的趋势。我们使用中断时间序列分析来比较COVID-19前期和后期的趋势。与2019年相比，2020年3月至7月的初级保健总访问量下降了28.0%，从每1000人/天7.66次降至5.51次。降幅最小的是预期医疗保健使用率最高的患者（8.3%），无法归因于初级保健医生的患者（10.2%）和老年人（19.1%）。相比之下，农村地区的总访问量增加了6.4%。办公室就诊减少了79.1%，虚拟医疗增加了56倍，占初级保健医生就诊的71.1%。虚拟护理使用率最低的是儿童（57.6%）、农村居民（60.6%）和分组≥2500名患者的医生（66.0%）。在2019冠状病毒病大流行的头4个月，安大略省的初级保健出现了从办公室到虚拟护理的大规模转变。在医疗保健需求较高的人群中，总访问量下降幅度最小。护理方面这些重大转变的决定因素和后果需要进一步研究。
Globally, primary care changed dramatically as a result of the coronavirus disease 2019 (COVID-19) pandemic. We aimed to understand the degree to which office and virtual primary care changed, and for which patients and physicians, during the initial months of the pandemic in Ontario, Canada. This population-based study compared comprehensive, linked primary care physician billing data from Jan. 1 to July 28, 2020, with the same period in 2019. We identified Ontario residents with at least 1 office or virtual (telephone or video) visit during the study period. We compared trends in total physician visits, office visits and virtual visits before COVID-19 with trends after pandemic-related public health measures changed the delivery of care, according to various patient and physician characteristics. We used interrupted time series analysis to compare trends in the early and later halves of the COVID-19 period. Compared with 2019, total primary care visits between March and July 2020 decreased by 28.0%, from 7.66 to 5.51 per 1000 people/day. The smallest declines were among patients with the highest expected health care use (8.3%), those who could not be attributed to a primary care physician (10.2%), and older adults (19.1%). In contrast, total visits in rural areas increased by 6.4%. Office visits declined by 79.1% and virtual care increased 56-fold, comprising 71.1% of primary care physician visits. The lowest uptake of virtual care was among children (57.6%), rural residents (60.6%) and physicians with panels of ≥ 2500 patients (66.0%). Primary care in Ontario saw large shifts from office to virtual care over the first 4 months of the COVID-19 pandemic. Total visits declined least among those with higher health care needs. The determinants and consequences of these major shifts in care require further study.
登录
查看更多内容
影响因子：
39.2
作者：
Srinivasan, Malathi;Asch, Steven;Artandi, Maja
通讯作者：
Artandi, Maja
影响因子：
9.7
作者：
Lau, Jen;Knudsen, Janine;Chokshi, Dave A.
通讯作者：
Chokshi, Dave A.
DOI：
10.9778/cmajo.20170083
发表时间：
2017-12-19
期刊：
CMAJ open
影响因子：
--
作者：
Schultz, Susan E;Glazier, Richard H
通讯作者：
Glazier, Richard H
影响因子：
8.5
作者：
Olayiwola, J Nwando;Magana, Candy;Wexler, Randy
通讯作者：
Wexler, Randy
影响因子：
--
作者：
Hardcastle, Lorian;Ogbogu, Ubaka
通讯作者：
Ogbogu, Ubaka