It, therefore, presents an opportunity to examine shifts in care at a population-level. In Ontario, the most populated province in Canada, the healthcare system is publicly funded and the data we used covers all healthcare services used. The extent at which virtual care adoption was maintained throughout later stages of the pandemic is also still unknown. It is currently unclear how the shift towards virtual care during the pandemic may have impacted chronic disease management and if virtual care was able to compensate for pandemic-related drops in in-person visits.

hospitalizations, emergency department visits). Such reductions in in-person visits and hospitalizations may lead to higher rates of future healthcare utilization during later stages of the pandemic (e.g. Additionally, reports of hospitalizations across various jurisdictions have demonstrated that there was a general decline in hospitalizations across many chronic conditions, especially early in the pandemic. Similarly, in Ontario, Canada, a study reported 89% fewer preventative primary care visits. A study from the USA reported a 90% reduction in rates of screening and prevention services. The COVID-19 pandemic has also led to challenges in the care of patients with chronic disease. With unprecedented levels of virtual care use, policy makers and payors are concerned about the quality of care being delivered virtually and potential increases in costs due to higher healthcare utilization. In Ontario, Canada, in the first 3 months of the pandemic 70% of all ambulatory visits were conducted virtually (telephone or video) and 86% of physicians conducted at least one virtual care visit. This has led to a significant adoption of virtual care services globally as a means to continue seeing patients while minimizing the cost of contact. The 2019 novel coronavirus (COVID-19) pandemic has forced healthcare systems to balance the risk of COVID infection with the potential negative impacts of delaying care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. All billing codes used are listed in the Supporting information files.įunding: This work was funded through the Ontario Ministry of Health as funds provided to the Centre for Digital Health Evaluation at Women’s College Hospital, Toronto, Ontario. A list of all datasets used is available in the paper. We are happy to share our data creation plan specifying our analyses if you contact the corresponding author and in turn you can use the information in the data creation plan to run the same or follow-up analyses.

Projects requesting access to data require the approval of a research ethics board. DAS staff will contact the requestor to discuss the project’s feasibility, timeline and cost. Researchers, students, policy makers or knowledge users who are affiliated with a publicly funded, not-for-profit organization and who want to obtain and analyze ICES data to answer a research question may submit a request to ICES DAS ( ). This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: The data is not publicly available and access is limited to the Institute for Clinical Evaluative Sciences (ICES) ( ), which is a prescribed entity under section 45 of Ontario’s Personal Health Information Protection Act (PHIPA).

Received: AugAccepted: ApPublished: April 25, 2022Ĭopyright: © 2022 Stamenova et al. Orueta, Osakidetza Basque Health Service, SPAIN (2022) 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. Citation: Stamenova V, Chu C, Pang A, Fang J, Shakeri A, Cram P, et al.

Virtual health care visits