{"id":16478,"date":"2023-05-15T13:54:00","date_gmt":"2023-05-15T17:54:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&p=16478"},"modified":"2023-07-27T14:03:30","modified_gmt":"2023-07-27T18:03:30","slug":"clinical-and-economic-impact-of-a-community-based-hybrid-model-of-in-person-and-virtual-care-in-a-canadian-rural-setting","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/clinical-and-economic-impact-of-a-community-based-hybrid-model-of-in-person-and-virtual-care-in-a-canadian-rural-setting\/","title":{"rendered":"Clinical and economic impact of a community-based, hybrid model of in-person and virtual care in a Canadian rural setting: a cross-sectional population-based comparative study"},"content":{"rendered":"

Objectives<\/strong> \u2014 To determine the clinical and economic impact of a community-based, hybrid model of in-person and virtual care by comparing health-system performance of the rural jurisdiction where this model was implemented with neighbouring jurisdictions without such a model and the broader regional health system.<\/p>\n

Design<\/strong> \u2014 A cross-sectional comparative study.<\/p>\n

Setting<\/strong> \u2014 Ontario, Canada, with a focus on three largely rural public health units from 1 April 2018 until 31 March 2021.<\/p>\n

Participants<\/strong> \u2014 All residents of Ontario, Canada under the age of 105 eligible for the Ontario Health Insurance Plan during the study period.<\/p>\n

Interventions<\/strong> \u2014 An innovative, community-based, hybrid model of in-person and virtual care, the Virtual Triage and Assessment Centre (VTAC), was implemented in Renfrew County, Ontario on 27 March 2020.<\/p>\n

Main Outcome Measures<\/strong> \u2014 Primary outcome was a change in emergency department (ED) visits anywhere in Ontario, secondary outcomes included changes in hospitalisations and health-system costs, using per cent changes in mean monthly values of linked health-system administrative data for 2 years preimplementation and 1 year postimplementation.<\/p>\n

Results<\/strong> \u2014 Renfrew County saw larger declines in ED visits (\u221234.4%, 95% CI \u221241.9% to \u221226.0%) and hospitalisations (\u221211.1%, 95% CI \u221219.7% to \u22121.5%) and slower growth in health-system costs than other rural regions studied. VTAC patients\u2019 low-acuity ED visits decreased by \u221232.9%, high-acuity visits increased by 8.2%, and hospitalisations increased by 30.0%.<\/p>\n

Conclusion<\/strong> \u2014 After implementing VTAC, Renfrew County saw reduced ED visits and hospitalisations and slower health-system cost growth compared with neighbouring rural jurisdictions. VTAC patients experienced reduced unnecessary ED visits and increased appropriate care. Community-based, hybrid models of in-person and virtual care may reduce the burden on emergency and hospital services in rural, remote and underserved regions. Further study is required to evaluate potential for scale and spread.<\/p>\n","protected":false},"excerpt":{"rendered":"

Objectives \u2014 To determine the clinical and economic impact of a community-based, hybrid model of in-person and virtual care by comparing health-system performance of the rural jurisdiction where this model was implemented with neighbouring jurisdictions without such a model and the broader regional health system. Design \u2014 A cross-sectional comparative study. Setting \u2014 Ontario, Canada, […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[62,28],"migration-helper-qa-sample-set":[],"class_list":["post-16478","journal_article","type-journal_article","status-publish","hentry","topic-health-services-research","topic-primary-care"],"acf":{"citation":"Fitzsimon JP, Belanger C, Glazier RH, Green M, Peixoto C, Mahdavi R, Plumptre L, Bjerre LM. BMJ Open<\/em>. 2023; 13(5):e069699. Epub 2023 May 15.","source_url":"https:\/\/doi.org\/10.1136\/bmjopen-2022-069699","ices_scientist":[1095,1250,1248,1163],"site":[6734],"research_program":[6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"\nICES | Clinical and economic impact of a community-based, hybrid model of in-person and virtual care in a Canadian rural setting: a cross-sectional population-based comparative study<\/title>\n<meta name=\"description\" content=\"Objectives \u2014 To determine the clinical and economic impact of a community-based, hybrid model of in-person and virtual care by comparing health-system\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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