Virtual care use during the COVID-19 pandemic and its impact on healthcare utilization in patients with chronic disease: A population-based repeated cross-sectional study.
Virtual care use during the COVID-19 pandemic and its impact on healthcare utilization in patients with chronic disease: A population-based repeated cross-sectional study.
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DOI：
10.1371/journal.pone.0267218
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Tadrous, Mina F.
中科院分区：
文献类型：
--
作者：
Stamenova, Vess;Chu, Cherry;Pang, Andrea;Fang, Jiming;Shakeri, Ahmad;Cram, Peter;Bhattacharyya, Onil F.;Bhatia, R. Sacha F.;Tadrous, Mina F.
目前尚不清楚2019年新型冠状病毒（COVID-19）大流行期间向虚拟医疗的转变可能如何影响人口层面的慢性病管理。我们研究的目的是描述加拿大安大略慢性病患者使用虚拟护理服务相对于亲自护理的水平，并描述低虚拟护理用户与高虚拟护理用户的医疗保健利用水平。我们使用关联的卫生管理数据，对加拿大安大略（2018年1月1日至2021年1月16日）所有门诊患者访视进行了一项基于人群的重复横断面研究。还完成了进一步分层，以检查COPD、心力衰竭、哮喘、高血压、糖尿病、精神疾病和心绞痛患者。患者被分类为低（最多1次虚拟护理访视）与高虚拟护理用户。使用干预性自回归积分移动平均（ARIMA）模型对每周住院、门诊访视和诊断试验进行时间序列分析。虚拟医疗的使用在所有慢性病患者人群中都有所增加。在所有条件下，虚拟护理至少占总护理的一半。在大流行开始时，低水平和高水平虚拟护理用户组的住院和实验室检测都出现了统计学上的显著减少。只有高使用者的住院量再次增加，而两组的检测量都增加了。高使用者的门诊人次未受疫情影响，但低使用者的门诊人次有所下降。在疫情期间，上门护理减少的同时，虚拟护理增加，最终使慢性病患者的就诊率恢复到疫情爆发前的水平。虚拟护理在各种慢性病中被采用，但虚拟护理的相对采用因条件而异，其中精神健康的比例最高。
It is currently unclear how the shift towards virtual care during the 2019 novel coronavirus (COVID-19) pandemic may have impacted chronic disease management at a population level. The goals of our study were to provide a description of the levels of use of virtual care services relative to in-person care in patients with chronic disease across Ontario, Canada and to describe levels of healthcare utilization in low versus high virtual care users. We used linked health administrative data to conduct a population-based, repeated cross-sectional study of all ambulatory patient visits in Ontario, Canada (January 1, 2018 to January 16, 2021). Further stratifications were also completed to examine patients with COPD, heart failure, asthma, hypertension, diabetes, mental illness, and angina. Patients were classified as low (max 1 virtual care visit) vs. high virtual care users. A time-series analysis was done using interventional autoregressive integrated moving average (ARIMA) modelling on weekly hospitalizations, outpatient visits, and diagnostic tests. The use of virtual care increased across all chronic disease patient populations. Virtual care constituted at least half of the total care in all conditions. Both low and high virtual care user groups experienced a statistically significant reduction in hospitalizations and laboratory testing at the start of the pandemic. Hospitalization volumes increased again only among the high users, while testing increased in both groups. Outpatient visits among high users remained unaffected by the pandemic but dropped in low users. The decrease of in-person care during the pandemic was accompanied by an increase in virtual care, which ultimately allowed patients with chronic disease to return to the same visit rate as they had before the onset of the pandemic. Virtual care was adopted across various chronic conditions, but the relative adoption of virtual care varied by condition with highest rates seen in mental health.
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DOI：
10.1503/cmaj.202303
发表时间：
2021-02-08
期刊：
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
影响因子：
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作者：
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DOI：
10.9778/cmajo.20200311
发表时间：
2021-01
期刊：
CMAJ open
影响因子：
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作者：
Bhatia RS;Chu C;Pang A;Tadrous M;Stamenova V;Cram P
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影响因子：
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