{"id":17133,"date":"2023-12-27T11:00:00","date_gmt":"2023-12-27T16:00:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=17133"},"modified":"2024-08-07T16:53:45","modified_gmt":"2024-08-07T20:53:45","slug":"virtual-visits-with-own-family-physician-vs-outside-family-physician-and-emergency-department-use","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/virtual-visits-with-own-family-physician-vs-outside-family-physician-and-emergency-department-use\/","title":{"rendered":"Virtual visits with own family physician vs outside family physician and emergency department use"},"content":{"rendered":"<p><strong>Importance<\/strong> \u2014 Virtual visits became more common after the COVID-19 pandemic, but it is unclear in what context they are best used.<\/p>\n<p><strong>Objective<\/strong> \u2014 To investigate whether there was a difference in subsequent emergency department use between patients who had a virtual visit with their own family physician vs those who had virtual visits with an outside physician.<\/p>\n<p><strong>Design, Setting, and Participants<\/strong> \u2014 This propensity score\u2013matched cohort study was conducted among all Ontario residents attached to a family physician as of April 1, 2021, who had a virtual family physician visit in the subsequent year (to March 31, 2022).<\/p>\n<p><strong>Exposure<\/strong> \u2014 The type of virtual family physician visit, with own or outside physician, was determined. In a secondary analysis, own physician visits were compared with visits with a physician working in direct-to-consumer telemedicine.<\/p>\n<p><strong>Main Outcome and Measure<\/strong> \u2014 The primary outcome was an emergency department visit within 7 days after the virtual visit.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 5 229 240 Ontario residents with a family physician and virtual visit, 4 173 869 patients (79.8%) had a virtual encounter with their own physician (mean [SD] age, 49.3 [21.5] years; 2 420 712 females [58.0%]) and 1 055 371 patients (20.2%) had an encounter with an outside physician (mean [SD] age, 41.8 [20.9] years; 605 614 females [57.4%]). In the matched cohort of 1 885 966 patients, those who saw an outside physician were 66%more likely to visit an emergency department within 7 days than those who had a virtual visit with their own physician (30 748 of 942 983 patients [3.3%] vs 18 519 of 942 983 patients [2.0%]; risk difference, 1.3% [95%CI, 1.2%-1.3%]; relative risk, 1.66 [95%CI, 1.63-1.69]). The increase in the risk of emergency department visits was greater when comparing 30 216 patients with definite direct-to-consumer telemedicine visits with 30 216 patients with own physician visits (risk difference, 4.1% [95%CI, 3.8%-4.5%]; relative risk, 2.99 [95%CI, 2.74-3.27]).<\/p>\n<p><strong>Conclusions and Relevance<\/strong> \u2014 In this study, patients whose virtual visit was with an outside physician were more likely to visit an emergency department in the next 7 days than those whose virtual visit was with their own family physician. These findings suggest that primary care virtual visits may be best used within an existing clinical relationship.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Importance \u2014 Virtual visits became more common after the COVID-19 pandemic, but it is unclear in what context they are best used. Objective \u2014 To investigate whether there was a difference in subsequent emergency department use between patients who had a virtual visit with their own family physician vs those who had virtual visits with [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,62,28],"migration-helper-qa-sample-set":[],"class_list":["post-17133","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-health-services-research","topic-primary-care"],"acf":{"citation":"Lapointe-Shaw L, Salahub C, Austin PC, Bai L, Bhatia RS, Bird C, Glazier RH, Hedden L, Ivers NM, Martin D, Shuldiner J, Spithoff S, Tadrous M, Kiran T. <em>JAMA Netw Open.<\/em> 2023; 6(12):e2349452. Epub 2023 Dec 27.","source_url":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.49452","ices_scientist":[1287,1385,1178,1250,1273,1108,1145],"site":[6733],"research_program":[6747],"news_release":[17134],"journal_article":"","atlas":"","research_report":"","infographic":[17135],"video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Virtual visits with own family physician vs outside family physician and emergency department use<\/title>\n<meta name=\"description\" content=\"Importance \u2014 Virtual visits became more common after the COVID-19 pandemic, but it is unclear in what context they are best used. 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