ArticleCMAJ open
Pediatric primary care in Ontario and Manitoba after the onset of the COVID-19 pandemic: a population-based study.
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28citing papers in PubMed
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Who cites it
28 citing papers in PubMed.
- Neurodevelopmental Diagnoses Before, During, and After the COVID-19 Pandemic.JAMA network open · 2026Article
- Emergency Department Visits for Minor Illnesses Among Recent Refugee and Immigrant Children.JAMA network open · 2026Article
- Impact of COVID-19 Pandemic on Pediatrics Primary Healthcare Visits in a University Based Family and Community Medicine Center in Saudi Arabia.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2026Article
- Virtual Care Provision and Emergency Department Use Among Children and Youth.JAMA network open · 2025Article
- Trends in missed paediatric preventive primary care visits during the COVID-19 pandemic using routinely collected electronic medical records in Ontario, Canada (2015-2022).Family medicine and community health · 2025Article
- The impact of the COVID-19 pandemic on longitudinal trends of surgical mortality and inpatient quality of care in Ontario, Canada.Journal of advanced nursing · 2025Article
- Impact of COVID-19 on the Diagnosis of Coarctation of the Aorta in Infants.Pediatric cardiology · 2025Article
- 2024 edition of the Rourke Baby Record.Canadian family physician Medecin de famille canadien · 2025Review
- Clinical Outcomes and Health Care Utilization in Patients with Advanced Chronic Kidney Disease not on Dialysis After the Onset of the COVID-19 Pandemic in Ontario, Canada.Canadian journal of kidney health and disease · 2025Article
- Clinical Outcomes and Healthcare Utilization in Patients Receiving Maintenance Dialysis After the Onset of the COVID-19 Pandemic in Ontario, Canada.Canadian journal of kidney health and disease · 2025Article
- Clinical Manifestations of Acute COVID-19 in Previously Healthy Pediatric Patients Diagnosed by Rapid Antigen Screening in a Community-Based, Outpatient Primary Care Pediatrics Practice.Children (Basel, Switzerland) · 2024Article
- Burden of Illness Associated With Respiratory Syncytial Virus, Influenza, and Coronavirus Disease 2019 in Infants and Young Children in Ontario, Canada, 2018-2023: A Population-Based Canadian Immunization Research Network Study.Open forum infectious diseases · 2024Article
- Healthcare visits for new neurodevelopmental problems before and during the COVID-19 pandemic.Pediatric research · 2024Article
- Growing inequities by immigration group among older adults: population-based analysis of access to primary care and return to in-person visits during the COVID-19 pandemic in British Columbia, Canada.BMC primary care · 2024Article
- Public funding for private for-profit centres and access to cataract surgery by patient socioeconomic status: an Ontario population-based study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Article
- Newborn readmissions and virtual primary care delivery: a population-based case-control study.BMC primary care · 2024Article
- Acute health care use among children during the first 2.5 years of the COVID-19 pandemic in Ontario, Canada: a population-based repeated cross-sectional study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- Gaps in childhood immunizations and preventive care visits during the COVID-19 pandemic: a population-based cohort study of children in Ontario and Manitoba, Canada, 2016-2021.Canadian journal of public health = Revue canadienne de sante publique · 2023Article
- Self-harm among youth during the first 28 months of the COVID-19 pandemic in Ontario, Canada: a population-based study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2023Article
Corrections and comments
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Authors and funding
13 authors.
Natasha SaundersThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man. Natasha.saunders@sickkids.ca.
Astrid GuttmannThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Marni BrownellThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Eyal CohenThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Longdi FuThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Jun GuanThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Joykrishna SarkarThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Alyson MaharThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Sima GandhiThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Lisa FiksenbaumThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Alan KatzThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Nkiruka EzeThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Therese A StukelThe Hospital for Sick Children (Saunders, Guttmann, Cohen); Department of Paediatrics (Saunders, Guttmann, Cohen), University of Toronto; ICES Central (Saunders, Guttmann, Cohen, Fu, Guan, Gandhi, Stukel); Child Health Evaluative Sciences (Saunders, Guttmann, Cohen, Fiksenbaum), SickKids Research Institute; Institute of Health Policy, Management and Evaluation (Saunders, Guttmann, Cohen, Stukel), Temerty Faculty of Medicine (Saunders, Guttmann, Cohen) and Edwin S.H. Leong Centre for Healthy Children (Saunders, Guttmann, Cohen), University of Toronto, Toronto, Ont.; Department of Community Health Sciences (Brownell, Mahar, Katz), University of Manitoba; Manitoba Centre for Health Policy (Brownell, Sarkar, Mahar, Katz, Eze); Children's Hospital Research Institute of Manitoba (Brownell); Department of Family Medicine (Katz), University of Manitoba, Winnipeg, Man.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere were large disruptions to health care services after the onset of the COVID-19 pandemic. We sought to describe the extent to which pandemic-related changes in service delivery and access affected use of primary care for children overall and by equity strata in the 9 months after pandemic onset in Manitoba and Ontario.
methodsWe performed a population-based study of children aged 17 years or less with provincial health insurance in Ontario or Manitoba before and during the COVID-19 pandemic (Jan. 1, 2017-Nov. 28, 2020). We calculated the weekly rates of in-person and virtual primary care well-child and sick visits, overall and by age group, neighbourhood material deprivation level, rurality and immigrant status, and assessed changes in visit rates after COVID-19 restrictions were imposed compared to expected baseline rates calculated for the 3 years before pandemic onset.
resultsAmong almost 3 million children in Ontario and more than 300 000 children in Manitoba, primary care visit rates declined to 0.80 (95% confidence interval [CI] 0.77-0.82) of expected in Ontario and 0.82 (95% CI 0.79-0.84) of expected in Manitoba in the 9 months after the onset of the pandemic. Virtual visits accounted for 53% and 29% of visits in Ontario and Manitoba, respectively. The largest monthly decreases in visits occurred in April 2020. Although visit rates increased slowly after April 2020, they had not returned to prerestriction levels by November 2020 in either province. Children aged more than 1 year to 12 years experienced the greatest decrease in visits, especially for well-child care. Compared to prepandemic levels, visit rates were lowest among rural Manitobans, urban Ontarians and Ontarians in low-income neighbourhoods.
interpretationDuring the study period, the pandemic contributed to rapid, immediate and inequitable decreases in primary care use, with some recovery and a substantial shift to virtual care. Postpandemic planning must consider the need for catch-up visits, and the long-term impacts warrant further study.
Indexed as
AdolescentAge DistributionAmbulatory CareChildChild, PreschoolCOVID-19Cross-Sectional StudiesDatabases, FactualEmigrants and ImmigrantsFemaleHumansInfantInfant, NewbornMaleManitobaOntario
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