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Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study

R. Sacha Bhatia, Cherry Chu, Andrea Pang, Mina Tadrous, Vess Stamenova and Peter Cram
February 17, 2021 9 (1) E107-E114; DOI: https://doi.org/10.9778/cmajo.20200311
R. Sacha Bhatia
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Cherry Chu
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Andrea Pang
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Mina Tadrous
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Vess Stamenova
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Peter Cram
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bhatia, Chu, Tadrous, Stamenova), Women’s College Hospital; ICES Central (Bhatia, Pang); Leslie Dan Faculty of Pharmacy (Tadrous), University of Toronto; Division of General Internal Medicine and Geriatrics (Cram), Sinai Health System and University Health Network; Department of Medicine (Cram), University of Toronto, Toronto, Ont.
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Article Figures & Tables

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  • Figure 1:
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    Figure 1:

    Rate of virtual visits per 1000 eligible Ontario patients by age group, 2012–2020.

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    Figure 2:

    Rate of virtual visits per 1000 eligible Ontario patients by neighbourhood income quintile, 2012–2020. Quintile 1 = lowest income quintile, quintile 5 = highest income quintile.

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    Figure 3:

    (A) Number of virtual visits compared to total ambulatory visits by quarter, 2012–2020. (B) Proportion of ambulatory visits that were virtual by quarter, 2012–2020. (C) Proportion of eligible Ontario patients with virtual visits by quarter, 2012–2020. (D) Number and proportion of providers who provided virtual care by quarter, 2012–2020.

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    Figure 4:

    Rate of virtual visits per 100 eligible Ontario patients by chronic disease, 2012–2020. Note: COPD = chronic obstructive pulmonary disease.

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    Table 1:

    Baseline characteristics of Ontario patients who received at least 1 virtual visit in 2012, 2016 or 2020, and those who received no virtual visits in 2020

    CharacteristicReceived at least 1 virtual visit; no. (%) of patientsp valueDid not receive any virtual visit in 2020; no. (%) of patients
    n = 3 162 395
    p value
    2012
    n = 51 186
    2016
    n = 146 104
    2020
    n = 4 927 830
    Age category, yr< 0.001< 0.001
     < 183379 (6.6)10 217 (7.0)523 361 (10.6)776 881 (24.6)
     18–4927 028 (52.8)74 561 (51.0)1 822 278 (37.0)1 227 511 (38.8)
     50–6410 874 (21.2)34 954 (23.9)1 232 489 (25.0)616 658 (19.5)
     65–797437 (14.5)19 956 (13.7)992 640 (20.1)378 914 (12.0)
     ≥ 802468 (4.8)6416 (4.4)357 062 (7.2)162 431 (5.1)
    Sex< 0.001< 0.001
     Female25 270 (49.4)73 102 (50.0)2 786 826 (56.6)1 628 796 (51.5)
     Male25 916 (50.6)73 002 (50.0)2 141 004 (43.4)1 533 599 (48.5)
    Region< 0.001< 0.001
     Central4609 (9.0)18 403 (12.6)1 707 781 (34.7)1 053 216 (33.3)
     East17 556 (34.3)38 709 (26.5)1 229 707 (25.0)741 447 (23.4)
     North20 389 (39.8)45 413 (31.1)238 786 (4.8)177 070 (5.6)
     Toronto1963 (3.8)4337 (3.0)454 743 (9.2)266 088 (8.4)
     West6669 (13.0)39 242 (26.9)1 296 813 (26.3)924 574 (29.2)
    Income quintile< 0.001< 0.001
     1 (lowest)13 658 (26.7)41 111 (28.1)943 988 (19.2)629 119 (19.9)
     210 182 (19.9)30 966 (21.2)974 288 (19.8)616 595 (19.5)
     39563 (18.7)27 545 (18.9)1 002 696 (20.3)638 517 (20.2)
     48362 (16.3)23 974 (16.4)999 831 (20.3)643 322 (20.3)
     5 (highest)8961 (17.5)22 247 (15.2)999 455 (20.3)625 919 (19.8)
     Missing460 (0.9)261 (0.2)7572 (0.2)8923 (0.3)
    Level of rurality (RIO score)< 0.001< 0.001
     Urban (< 40)33 356 (65.2)112 721 (77.2)4 604 587 (93.4)2 924 122 (92.5)
     Rural (≥ 40)14 666 (28.6)27 145 (18.6)290 401 (5.9)204 317 (6.5)
     Missing3164 (6.2)6238 (4.3)32 842 (0.7)33 956 (1.1)
    • Note: RIO = Rurality Index for Ontario.

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Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study
R. Sacha Bhatia, Cherry Chu, Andrea Pang, Mina Tadrous, Vess Stamenova, Peter Cram
Jan 2021, 9 (1) E107-E114; DOI: 10.9778/cmajo.20200311

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Virtual care use before and during the COVID-19 pandemic: a repeated cross-sectional study
R. Sacha Bhatia, Cherry Chu, Andrea Pang, Mina Tadrous, Vess Stamenova, Peter Cram
Jan 2021, 9 (1) E107-E114; DOI: 10.9778/cmajo.20200311
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