Impact of the COVID-19 Pandemic on Virtual Care: A Major Shift for Physicians and Patients.

To reduce the spread of COVID-19 in Canada, patients receiving physician services experienced a significant shift to virtual appointments by telephone, video conference and online messaging as many physician visits moved from in-person to virtual delivery. The Canadian Institute for Health Information's analysis of the physician billing data in five provinces (Ontario, Manitoba, Saskatchewan, Alberta and British Columbia) shows that during the first year of the pandemic in 2020, up to twice as many physicians provided care virtually compared to 2019. At the same time, the rate at which patients received virtual services quadrupled. Furthermore, data from the 2021 Commonwealth Fund (CMWF) survey of older adults show that almost twice as many Canadian seniors (71%) had a virtual appointment with a doctor or healthcare provider compared to seniors in other CMWF countries (39%). Going forward, virtual care remains a significant mode of delivery and has important implications for the future of patient care and the relationships between patients and providers.

Coordination of Care Could Improve: Canadian Results from the Commonwealth Fund International Health Policy Survey of Primary Care Physicians.

Care coordination is a critical component of a strong primary care system. The Commonwealth Fund (CMWF) 2019 International Health Policy Survey of Primary Care Physicians polled physicians in 11 countries, allowing international and pan-Canadian comparisons of physicians' perspectives in this area. Canadian physicians indicated that there was room for improvement in coordinating care with those outside their practice, particularly specialists, home-based care providers and social services. Opportunities may arise in learning from higher-performing CMWF countries and in adopting new information technologies that are growing methods of facilitating communication across care settings.

The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada.

OBJECTIVE: To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. DATA SOURCES/STUDY SETTING: Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. STUDY DESIGN: We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only). The double bootstrap procedure (Simar and Wilson 2007) is adopted in the regression. DATA COLLECTION/EXTRACTION METHODS: Information on inpatient episodes of care (number and quality of outcomes) was extracted from the DAD. The cost of the inpatient care was extracted from the CMDB. PRINCIPAL FINDINGS: On average, acute hospitals in Canada are operating at about 75 percent efficiency, and this could thus potentially increase their level of outcomes (quantity and quality) by addressing inefficiencies. In some cases, such as for teaching hospitals, the factors significantly correlated with efficiency scores were not related to management but to the social composition of the caseload. In contrast, for large and medium nonteaching hospitals, efficiency related more to the ability to discharge patients to postacute care facilities. The efficiency of medium hospitals is also positively related to treating more clinically noncomplex patients. CONCLUSIONS: The main drivers of efficiency of acute inpatient care vary by hospital peer groups. Thus, the results provide different policy and managerial implications for teaching, large, and medium hospitals to achieve efficiency gains.

Care for Patients with Complex Needs: Canadian Results from the Commonwealth Fund 2015 International Health Policy Survey of Primary Care Physicians.

Good primary care is essential for the effective management of patients with chronic conditions in the community and to ensure their care is well coordinated with other parts of the system. The Commonwealth Fund 2015 International Health Policy Survey compares the views and experiences of primary care physicians in 11 countries including Canada. The survey found nearly all (98%) primary care doctors across countries treat patients with complex needs in their practice. However, when examining questions on chronic disease management and coordination of care with other providers, Canadian results are mixed compared to the international average, and show variation at the provincial level. Opportunities likely exist to learn from other countries that have a more systematic approach to primary care delivery.