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EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-329790


Importance Virtual walk-in clinics have proliferated since the onset of COVID-19. Yet, little is known about those who participate in this care model, and how virtual walk-in clinics contribute to care continuity and patient healthcare utilization. Objectives To describe the characteristics and healthcare use of patients using virtual walk-in clinics compared to the general population, and a subset that received any virtual family physician visit. Design This was a retrospective, population-based, cross-sectional study. Setting Ontario, Canada’s most populous province. Participants Patients who had received at least one family physician visit at one of 13 virtual walk-in clinics from April 1 st to December 31 st , 2020. They were compared to Ontario residents who had any virtual family physician visit in the same time period. Main Outcome(s) and Measure(s) Patient characteristics and 30-day post-visit healthcare utilization. Results Virtual walk-in patients (N=132,168) had fewer comorbidities and lower previous healthcare utilization than Ontarians with any virtual visit. Less than 0.1% of virtual walk-in visits were with a patient’s own family physician. Compared to Ontarians having any virtual family physician visit, virtual walk-in patients were significantly less likely to have a subsequent in-person visit with the same physician (0.2% vs. 11.0%, SMD = 0.48), more likely to have a subsequent virtual visit (30.3% vs. 21.9%, SMD = 0.19), and twice as likely to have an emergency department visit within 30 days (8.3% vs. 4.1%, SMD = 0.18), an effect that persisted after adjustment and across rurality groups: large urban (aOR 2.26;95% CI 2.08-2.45), small urban (aOR 2.08;95% CI 1.99-2.18), and rural (aOR 1.87;95% CI 1.69-2.07). Conclusions and Relevance Compared to Ontarians attending any family physician virtual visit, virtual walk-in patients were less likely to have a subsequent in-person physician visit, but were more likely to visit the emergency department. Low continuity and the lack of physical examination may be contributing to increased emergency department utilization for virtual walk-in clinic patients.

BMJ Open ; 11(10): e053124, 2021 10 27.
Article in English | MEDLINE | ID: covidwho-1495470


INTRODUCTION: Communicable disease epidemics and pandemics magnify the health inequities experienced by marginalised populations. People who use substances suffer from high rates of morbidity and mortality and should be a priority to receive palliative care, yet they encounter many barriers to palliative care access. Given the pre-existing inequities to palliative care access for people with life-limiting illnesses who use substances, it is important to understand the impact of communicable disease epidemics and pandemics such as COVID-19 on this population. METHODS AND ANALYSIS: We will conduct a scoping review and report according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews reporting guidelines. We conducted a comprehensive literature search in seven bibliographical databases from the inception of each database to August 2020. We also performed a grey literature search to identify the publications not indexed in the bibliographical databases. All the searches will be rerun in April 2021 to retrieve recently published information because the COVID-19 pandemic is ongoing at the time of this writing. We will extract the quantitative data using a standardised data extraction form and summarise it using descriptive statistics. Additionally, we will conduct thematic qualitative analyses and present our findings as narrative summaries. ETHICS AND DISSEMINATION: Ethics approval is not required for a scoping review. We will disseminate our findings to healthcare providers and policymakers through professional networks, digital communications through social media platforms, conference presentations and publication in a scientific journal.

COVID-19 , Communicable Diseases , Humans , Palliative Care , Pandemics , Research Design , Review Literature as Topic , SARS-CoV-2 , Systematic Reviews as Topic