PT  - JOURNAL ARTICLE
AU  - Chami, Nadine
AU  - Shah, Hemant A.
AU  - Nastos, Steve
AU  - Shaikh, Shaun
AU  - Tenenbein, Paul K.
AU  - Lougheed, Taylor
AU  - Mizdrak, Nikolina
AU  - Conlon, Patrick
AU  - Wright, James G.
AU  - Weir, Sharada
AU  - Kantarevic, Jasmin
TI  - Association between virtual primary care and emergency department use during the first year of the COVID-19 pandemic in Ontario, Canada
AID  - 10.1503/cmaj.212051
DP  - 2023 Jan 23
TA  - Canadian Medical Association Journal
PG  - E108--E114
VI  - 195
IP  - 3
4099  - http://www.cmaj.ca/content/195/3/E108.short
4100  - http://www.cmaj.ca/content/195/3/E108.full
SO  - CMAJ2023 Jan 23; 195
AB  - Background: Uptake of virtual care increased substantially during the first year of the COVID-19 pandemic. The aim of this study was to evaluate whether a shift from in-person to virtual visits by primary care physicians was associated with increased use of emergency departments among their enrolled patients.Methods: We conducted an observational study of monthly virtual visits and emergency department visits from Apr. 1, 2020, to Mar. 31, 2021, using administrative data from Ontario, Canada. We used multivariable regression analysis to estimate the association between the proportion of a physician’s visits that were delivered virtually and the number of emergency department visits among their enrolled patients.Results: The proportion of virtual visits was higher among female, younger and urban physicians, and the number of emergency department visits was lower among patients of female and urban physicians. In an unadjusted analysis, a 1% increase in a physician’s proportion of virtual visits was found to be associated with 11.0 (95% confidence interval [CI] 10.1–11.8) fewer emergency department visits per 1000 rostered patients. After controlling for covariates, we observed no statistically significant change in emergency department visits per 1% increase in the proportion of virtual visits (0.2, 95% CI −0.5 to 0.9).Interpretation: We did not find evidence that patients substituted emergency department visits in the context of decreased availability of in-person care with their family physician during the first year of the COVID-19 pandemic. Future research should focus on the long-term impact of virtual care on access and quality of patient care.