ArticleBMJ open2023
Clinical and economic impact of a community-based, hybrid model of in-person and virtual care in a Canadian rural setting: a cross-sectional population-based comparative study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- How do interventions in primary care or in emergency departments impact less urgent patients' emergency care utilization? A systematic review.BMC health services research · 2026Pooled it
- Virtual Care and Telehealth for Improving Healthcare Access in Rural Western Canada and the Western United States: A Scoping Review and Narrative Synthesis.Journal of clinical medicine · 2026Review
- Implementing the Virtual Integrated Practice (VIP) Program to Support Rural General Practice Viability in Australia.The Australian journal of rural health · 2026Article
- Keeping the door open: virtual coverage of rural emergency departments-what works and what doesn't.CJEM · 2025Article
- Assessing patient experiences with a Virtual Triage and Assessment Centre (VTAC): a mixed-methods study using an online survey and semi-structured interviews in Renfrew County, Ontario.BMC primary care · 2025Article
- The Experience and the Characteristics of Patients With Tele-ICU Implementation in a Rural Community Hospital.Cureus · 2023Article
- Family physicians' experiences with an innovative, community-based, hybrid model of in- person and virtual care: a mixed-methods study.BMC health services research · 2023Article
- Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine the clinical and economic impact of a community-based, hybrid model of in-person and virtual care by comparing health-system performance of the rural jurisdiction where this model was implemented with neighbouring jurisdictions without such a model and the broader regional health system.
designA cross-sectional comparative study.
settingOntario, Canada, with a focus on three largely rural public health units from 1 April 2018 until 31 March 2021.
participantsAll residents of Ontario, Canada under the age of 105 eligible for the Ontario Health Insurance Plan during the study period.
interventionsAn innovative, community-based, hybrid model of in-person and virtual care, the Virtual Triage and Assessment Centre (VTAC), was implemented in Renfrew County, Ontario on 27 March 2020.
main outcome measuresPrimary outcome was a change in emergency department (ED) visits anywhere in Ontario, secondary outcomes included changes in hospitalisations and health-system costs, using per cent changes in mean monthly values of linked health-system administrative data for 2 years preimplementation and 1 year postimplementation.
resultsRenfrew County saw larger declines in ED visits (-34.4%, 95% CI -41.9% to -26.0%) and hospitalisations (-11.1%, 95% CI -19.7% to -1.5%) and slower growth in health-system costs than other rural regions studied. VTAC patients' low-acuity ED visits decreased by -32.9%, high-acuity visits increased by 8.2%, and hospitalisations increased by 30.0%.
conclusionAfter implementing VTAC, Renfrew County saw reduced ED visits and hospitalisations and slower health-system cost growth compared with neighbouring rural jurisdictions. VTAC patients experienced reduced unnecessary ED visits and increased appropriate care. Community-based, hybrid models of in-person and virtual care may reduce the burden on emergency and hospital services in rural, remote and underserved regions. Further study is required to evaluate potential for scale and spread.
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