Evidence map›Paper›PMID 40455792›Full record

Observational studyPloS one2025

A retrospective evaluation of access equity in virtual care during the COVID-19 pandemic: A 2-year review and comparison of visits in Ontario, Canada.

Shawn Mondoux, Frank Battaglia, Anastasia Gayowsky, Natasha Clayton, Caillin Langmann, Paul Miller, Alim Pardhan, Julie Matthews, Alexander Drossos, Keerat Grewal

Abstract readObservational StudyComparative Study
In one paragraph

Observational study in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Shawn MondouxDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-6752-3485
Frank BattagliaDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.ORCID https://orcid.org/0000-0002-4690-7930
Anastasia GayowskyICES, Toronto, Ontario, Canada.
Natasha ClaytonSt. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
Caillin LangmannDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
Paul MillerDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
Alim PardhanDepartment of Medicine, Division of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada.
Julie MatthewsHamilton Health Sciences, Hamilton, Ontario, Canada.
Alexander DrossosDepartment of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.
Keerat GrewalSchwartz/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccess equity has been raised as a fundamental concern with virtual care, both as it was used during the SARS-CoV-2 pandemic as well as its future applications within health systems. These concerns have not yet been substantiated with quantifiable data. We conducted a comparison of healthcare utilization and access across all dimensions of the Ontario Marginalization Index between virtual care and in-person care in the province of Ontario.

methodsWe conducted a retrospective observational study using ICES databases in the Province of Ontario between March 14, 2020, and March 13,2022. We identified all virtual and in-person visits using billing codes. All visits were linked to their individual postal dissemination area for which there was census data from the Ontario Marginalization Index. Dissemination areas were divided, according to their categorization within each marginalization dimension, and visit rates were calculated for both populations.

resultsA total of 93,363,194 visits were included as part of the final analysis. Significant differences in virtual healthcare utilization were noted between the most and least marginalized populations within each dimension. This effect was not observed by visits for in-person care. The only exception was that racialized, and newcomer populations had higher virtual care utilization among the most marginalized.

interpretationThis data is the first that uses a large retrospective dataset and seems to confirm concerns for access inequity among the most marginalized populations. These differences much be part of policy considerations for the future of virtual care use.

Indexed as

COVID-19Health Services AccessibilityTelemedicineAdultAgedFemaleHumansMaleMiddle AgedOntarioPandemicsPatient Acceptance of Health CareRetrospective StudiesSARS-CoV-2

Identifiers

PMID40455792
PMCPMC12129146

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.