Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data
Objective The objective was to analyse how the pandemic affected primary care access and comprehensiveness in chronic disease management by comparing primary care patterns before and during the early COVID-19 pandemic.Design We conducted a quasi-experimental pre–post design cohort study and reported...
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BMJ Publishing Group
2024-05-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/5/e084608.full |
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| author | Kris Aubrey-Bassler Michelle Howard Jennifer Lawson Dee Mangin Meredith Vanstone Neil Drummond Kathryn Nicholson Marie-Thérèse Lussier John Queenan Shuaib Hafid Karla Freeman |
| author_facet | Kris Aubrey-Bassler Michelle Howard Jennifer Lawson Dee Mangin Meredith Vanstone Neil Drummond Kathryn Nicholson Marie-Thérèse Lussier John Queenan Shuaib Hafid Karla Freeman |
| author_sort | Kris Aubrey-Bassler |
| collection | DOAJ |
| description | Objective The objective was to analyse how the pandemic affected primary care access and comprehensiveness in chronic disease management by comparing primary care patterns before and during the early COVID-19 pandemic.Design We conducted a quasi-experimental pre–post design cohort study and reported indicators for the 21 months before and after the onset of the COVID-19 pandemic.Setting We used electronic medical record data from primary care clinics enrolled in the Canadian Primary Care Sentinel Surveillance Network from 1 January 2018 to 31 December 2021.Population The study population included patients (n=919 928) aged 18 years or older with at least one primary care contact from 12 March 2018 to 12 March 2020, in Canada.Outcome measures The study indicators included three indicators measuring access to primary care (encounters, blood pressure measurements and lab tests) and three for comprehensiveness (diagnoses, non-COVID-19 vaccines administered and referrals).Results 67.3% of the cohort was aged ≥40 years, 56.4% were female and 53.5% were from Ontario, Canada. Fewer patients received an encounter during the pandemic (91.5% to 81.5%), while the median (IQR) number of encounters remained the same (5 (2–1)) for those with access. Fewer patients received a blood pressure measurement (47.9% to 31.8%), and patients received fewer measurements during the pandemic (2 (1–4) to 1 (0–2)).Conclusions Encounters with primary care remained consistent during the pandemic, but in-person care, such as lab tests and blood pressure measurements, decreased. In-person care indicators followed temporally to national COVID-19 case counts during the pandemic. |
| format | Article |
| id | doaj-art-3ebdd73e5a7648a289b80e71f37313d5 |
| institution | DOAJ |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-3ebdd73e5a7648a289b80e71f37313d52025-08-20T02:40:52ZengBMJ Publishing GroupBMJ Open2044-60552024-05-0114510.1136/bmjopen-2024-084608Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network dataKris Aubrey-Bassler0Michelle Howard1Jennifer Lawson2Dee Mangin3Meredith Vanstone4Neil Drummond5Kathryn Nicholson6Marie-Thérèse Lussier7John Queenan8Shuaib Hafid9Karla Freeman10Primary Healthcare Research Unit, Memorial University of Newfoundland, St. John`s, Newfoundland, CanadaDepartment of Family Medicine, McMaster University, Hamilton, Ontario, CanadaFamily Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaFamily Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaFamily Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaFamily Medicine, University of Alberta, Edmonton, Alberta, CanadaEpidemiology and Biostatistics, Western University, London, Ontario, CanadaMédecine de famille et de médecine d’urgence, Université de Montréal, Montréal, Québec, CanadaFamily Medicine, Queen`s University, Kingston, Ontario, CanadaFamily Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaFamily Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, CanadaObjective The objective was to analyse how the pandemic affected primary care access and comprehensiveness in chronic disease management by comparing primary care patterns before and during the early COVID-19 pandemic.Design We conducted a quasi-experimental pre–post design cohort study and reported indicators for the 21 months before and after the onset of the COVID-19 pandemic.Setting We used electronic medical record data from primary care clinics enrolled in the Canadian Primary Care Sentinel Surveillance Network from 1 January 2018 to 31 December 2021.Population The study population included patients (n=919 928) aged 18 years or older with at least one primary care contact from 12 March 2018 to 12 March 2020, in Canada.Outcome measures The study indicators included three indicators measuring access to primary care (encounters, blood pressure measurements and lab tests) and three for comprehensiveness (diagnoses, non-COVID-19 vaccines administered and referrals).Results 67.3% of the cohort was aged ≥40 years, 56.4% were female and 53.5% were from Ontario, Canada. Fewer patients received an encounter during the pandemic (91.5% to 81.5%), while the median (IQR) number of encounters remained the same (5 (2–1)) for those with access. Fewer patients received a blood pressure measurement (47.9% to 31.8%), and patients received fewer measurements during the pandemic (2 (1–4) to 1 (0–2)).Conclusions Encounters with primary care remained consistent during the pandemic, but in-person care, such as lab tests and blood pressure measurements, decreased. In-person care indicators followed temporally to national COVID-19 case counts during the pandemic.https://bmjopen.bmj.com/content/14/5/e084608.full |
| spellingShingle | Kris Aubrey-Bassler Michelle Howard Jennifer Lawson Dee Mangin Meredith Vanstone Neil Drummond Kathryn Nicholson Marie-Thérèse Lussier John Queenan Shuaib Hafid Karla Freeman Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data BMJ Open |
| title | Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data |
| title_full | Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data |
| title_fullStr | Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data |
| title_full_unstemmed | Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data |
| title_short | Describing primary care patterns before and during the COVID-19 pandemic across Canada: a quasi-experimental pre–post design cohort study using national practice-based research network data |
| title_sort | describing primary care patterns before and during the covid 19 pandemic across canada a quasi experimental pre post design cohort study using national practice based research network data |
| url | https://bmjopen.bmj.com/content/14/5/e084608.full |
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