Journal Article

Primary care utilization for patients with newly diagnosed cancer during the COVID-19 pandemic: a population-based study

Cheung, Matthew C., Liu, Ning, Chan, Kelvin K.W., Lofters, Aisha, Ling, Ying, Singh, Simron, Patrikar, Aditi, Fox, Colleen

2022

Overview

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.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Biomedical and Life Sciences / Biomedicine / Cancer / Cancer patients / Cancer Research / Cancer therapies / Care and treatment / Control / Coronaviruses / COVID-19 / COVID-19 diagnostic tests / COVID-19 pandemic / Emergency medical care / Epidemics / Health care policy / Health Promotion and Disease Prevention / Hospitalization / Malignancy / Medical care / Medical diagnosis / Medical screening / Medicine/Public Health / Oncology / Pandemics / Patients / Personal health / Physicians (General practice) / Population / Population studies / Population-based studies / Primary care / Prostate / Radiation / Regression analysis / Services / Surgical Oncology / Telemedicine / Utilization / Virtual care