Evidence map›Paper›PMID 40983382›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2025

Changes in driving distance to specialist physicians in the era of virtual care: a population-based cohort study in Ontario, Canada.

Andrea Evans, Eyal Cohen, Therese A Stukel, Zharmaine Ante, Xuesong Wang, Tharani Raveedran, Peter Gozdyra, Natasha Saunders

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Caregiver attitudes toward testicular tissue cryopreservation in prepubertal male cancer/HSCT patients A non-metropolitan, Canadian cohort.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Article
  3. 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

8 authors.

Andrea EvansDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Eyal CohenDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Therese A StukelDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Zharmaine AnteDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Xuesong WangDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Tharani RaveedranDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Peter GozdyraDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont.
Natasha SaundersDepartment of Pediatrics (Evans), University of Ottawa; Division of Pediatric Medicine (Evans), Children's Hospital of Eastern Ontario, Ottawa, Ont.; ICES Central (Evans, Cohen, Stukel, Ante, Wang, Gozdyra, Saunders); The Hospital for Sick Children (Cohen, Saunders); Department of Pediatrics (Cohen, Saunders), University of Toronto; Child Health Evaluative Sciences (Cohen, Raveedran, Saunders), SickKids Research Institute; Institute for Health Policy, Management and Evaluation (Cohen, Stukel, Saunders), University of Toronto; Edwin S.H. Leong Centre for Health Children (Cohen, Saunders), University of Toronto, Toronto, Ont. natasha.saunders@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhether virtual health care has changed access to services for patients living far from a specialist physician is unknown. We aimed to determine whether driving distances between patients and their specialists had changed following increased availability of virtual care in Ontario, such that specialists saw patients from farther away.

methodsWe performed a population-based cohort study using linked health and administrative databases. We included all specialist physicians working in Ontario from Jan. 1, 2019, to Nov. 30, 2019 (pre-virtual care period) and from Jan. 1, 2022, to Nov. 30, 2022 (virtual care period), and their patients. Outcomes were measures of proximity between specialists and their patients including differences in 90th-percentile driving distance, mean driving time, and the proportion of patients with driving times longer than 60 minutes between time periods. We used multivariable linear regression models to compare outcomes across physician specialties, adjusting for physician age, sex, practice size, and location.

resultsWe included 11 096 specialists (4232 surgical and 6864 medical; 0.8% rural). After adjustment, we found no meaningful changes in the 90th-percentile driving distance between time periods for surgical (difference 6.7 km, 95% confidence interval [CI] -4.1 km to 17.5 km) or medical specialties (difference 1.3 km, 95% CI -6.6 km to 9.2 km). For surgical specialists, the proximity measures of mean driving time increased by 5 minutes (95% CI 1 min to 10 min) and the proportion of patients living more than 60 minutes away increased by 2.1% (95% CI 0.7% to 3.9%), but we saw no significant change for medical specialists.

interpretationAfter expansion of virtual care, the distance between specialists and patients did not meaningfully change. To make virtual care more accessible, especially for those living in rural areas, attention should be paid to other factors such as referral patterns and the role of patients in determining the type of visit they prefer.

Indexed as

Automobile DrivingHealth Services AccessibilityPhysiciansSpecializationTelemedicineAdultCohort StudiesFemaleHumansMaleMiddle AgedOntario

Identifiers

PMID40983382
PMCPMC12479117

What OpenQuestion holds

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Registered trials

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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.