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Primary care utilization for patients with newly diagnosed cancer during the COVID-19 pandemic: a population-based study.
Ling, Ying; Cheung, Matthew C; Chan, Kelvin K W; Lofters, Aisha; Fox, Colleen; Patrikar, Aditi; Liu, Ning; Singh, Simron.
  • Ling Y; Division of Hematology, Department of Medicine, University of Toronto, Toronto, Canada. ying.ling@williamoslerhs.ca.
  • Cheung MC; Division of Hematology, Department of Medicine, University of Toronto, Toronto, Canada.
  • Chan KKW; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Lofters A; ICES, Toronto, Canada.
  • Fox C; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
  • Patrikar A; ICES, Toronto, Canada.
  • Liu N; Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Canada.
  • Singh S; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
BMC Cancer ; 22(1): 1133, 2022 Nov 04.
Article in English | MEDLINE | ID: covidwho-2108750
ABSTRACT

BACKGROUND:

The COVID-19 pandemic greatly impacted primary care and cancer care. We studied how primary care utilization in Ontario, Canada changed for patients who were newly diagnosed with cancer just prior to the COVID-19 pandemic compared to those diagnosed in non-pandemic years.

METHODS:

This population-based, retrospective cohort study used linked healthcare databases to compare outcomes for patients with a new malignancy diagnosed within the year prior to the COVID-19 pandemic, between July 1 and September 30, 2019 (COVID-19 cohort) to those diagnosed in the same months in 2018 and 2017 (pre-pandemic cohort). We used Poisson regression models to compare rates of in-person and virtual visits to patients' usual primary care physician (PCP), emergency department (ED) visits, and hospitalizations, all reported per person-year of follow-up.

RESULTS:

In-person visits to usual PCPs decreased from 4.07/person-year in the pre-pandemic cohort to 2.58 in the COVID-19 cohort (p < 0.0001). Virtual visits to usual PCPs increased from 0.00 to 1.53 (p < 0.0001). Combined in-person and virtual visits to patients' usual PCPs was unchanged from 4.07 to 4.12 (p = 0.89). The rate of ED visits decreased from 0.99/person-year to 0.88 (p < 0.0001). Non-elective hospitalizations remained unchanged, from 0.49/person-year to 0.47 (p = 0.1675).

CONCLUSION:

There was a sizeable shift in primary care visits for cancer patients from in-person to virtual during the pandemic, although there was no resultant increase in hospitalizations. This suggests that early in the pandemic, virtual care allowed for continuity in utilization of primary care, though further studies are required to confirm this persisted later in the pandemic.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Cancer Journal subject: Neoplasms Year: 2022 Document Type: Article Affiliation country: S12885-022-10257-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Neoplasms Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: BMC Cancer Journal subject: Neoplasms Year: 2022 Document Type: Article Affiliation country: S12885-022-10257-4