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The impact of COVID-19 on Ontario’s health care system

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Background

The impact of the COVID-19 pandemic has been felt worldwide, with hospitalization, death and the long-term effects of infection being its immediate and enduring consequences. The virus and subsequent efforts to stop its rapid spread have altered the way health care systems operate. Everyone, including patients, have been told to limit their activities outside their homes, and health systems have had to rapidly adapt their delivery of patient care to include a shift to virtual care and coping with delays in diagnostic screening, childhood immunization, and surgery. The pandemic’s long-term impacts on the delivery of health care likely won’t be fully realized for years to come.

ICES Research

A March 2021 study led by ICES scientists Drs. Rick Glazier and Tara Kiran found an 80% decrease in primary care office visits in Ontario in the first four months of the pandemic; this was accompanied by a shift to virtual care visits that represented nearly two-thirds of all physician visits. While telemedicine had been available in rural and remote communities for several years before the start of the pandemic, a January 2021 ICES study led by Dr. Sacha Bhatia found there wasn’t a significant uptake in its use until government-ordered lockdowns and travel restrictions highlighted its role. That study’s findings provide some reassurance that groups with the greatest care needs, including older adults and those with higher levels of morbidity, continued to receive relatively high levels of care overall. 

Patients weren’t just avoiding doctors’ offices during the first wave of the pandemic. Emergency department visits declined significantly for common conditions such as appendicitis, miscarriage, gallbladder attacks and ectopic pregnancy. But again, patient outcomes didn’t worsen.

Areas of impact

In Ontario hospitals, the reallocation of resources such as beds, ventilators and medical staff to manage the surge in COVID-19 admissions resulted in an immediate cancellation of 60% of cancer surgeries. A March 2021 study led by ICES scientists Drs. Antoine Eskander and Rinku Sutradhar showed a significant cancer surgery backlog, which the Ontario COVID-19 Science Advisory Table characterized as an enormous challenge for the post-pandemic recovery phase in the province.

How this work is having impact

  • To date, ICES has conducted more than 40 studies on COVID’s effect on medical conditions and service delivery.
  • The Ontario Ministry of Health introduced temporary billing codes for physician visits conducted by telephone or video conferencing and is assessing their permanent adoption.
  • In January 2021, the Ministry of Health introduced its Digital First for Health Strategy, which enables patients to access more virtual-care options.
  • Dr. Eskander presented his ideas for using data to increase the efficiency of cancer care to the federal government’s Parliamentary Health Research Caucus in May 2021.
  • In July 2021, the Ontario government and the Ministry of Health announced additional funding to reduce wait times for diagnostic imaging and surgery.
  • Cancer Care Ontario has used ICES data to inform its models on measuring the surgery backlog.

“The value of ICES data isn’t just the data. It’s the expertise held within the organization by people who are used to working with the data, who meticulously, honestly and comprehensively answer some of the most pressing questions facing our health care system. This has been especially true during the COVID-19 pandemic. The research team that completed this work has had a long history of working with data and understands its strengths and weaknesses. The data alone is not powerful; it’s the team that brings it to life and allows us to tell the real story.”
Dr. Antoine Eskander, ICES adjunct scientist and surgical oncologist

 

Posted December 2021

Published in the 2020-21 Annual Report

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