Evidence map›Paper›PMID 41587841›Full record

ArticleAnnals of family medicine2026

Impact of Incentive Reform and COVID-19 on Primary Care Home Visits in Ontario: A Population-Based Interrupted Time Series Analysis.

Aaron Jones, Anastasia Gayowsky, Chi-Ling Joanna Sinn, Rebecca H Correia, Darly Dash, Bahram Rahman, Maggie Hong Meng, Heebah Sultan, Elizabeth Niedra, Andrew P Costa and 4 more

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Article in Annals of family medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

14 authors.

Aaron JonesDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada jonesa13@mcmaster.ca.
Anastasia GayowskyICES, Toronto, Ontario, Canada.
Chi-Ling Joanna SinnCentre for Integrated Care, St Joseph's Health System, Hamilton, Ontario, Canada.
Rebecca H CorreiaDepartment of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Darly DashDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Bahram RahmanDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Maggie Hong MengHealth Standards Organization, Ottawa, Canada.
Heebah SultanOntario Health, Toronto, Ontario, Canada.
Elizabeth NiedraVHA Home Health Care, Toronto, Canada.
Andrew P CostaDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Noah IversICES, Toronto, Ontario, Canada.
R Liisa JaakkimainenICES, Toronto, Ontario, Canada.
Jennifer A WattICES, Toronto, Ontario, Canada.
Lauren Lapointe-ShawICES, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHome visits provide essential access to primary care for frail or homebound older adults. In Ontario, Canada, a 2019 policy change removed some financial incentives for physicians to conduct home visits. This was followed by the COVID-19 pandemic and rapid adoption of virtual care, potentially disrupting the provision of home visits.

methodsWe conducted a population-based interrupted time series analysis of Ontario residents aged ≥65 years during the period July 2014 to June 2024. The interruptions were an incentive reform in October 2019 and the onset of COVID-19 in March 2020. The main outcome was the monthly number of primary care home visits per 10,000 older adults, standardized by age and sex. Segmented autoregressive models estimated changes in level and trend at interruption. Secondary analyses examined differences by age, rurality, dementia status, and visit type (palliative vs nonpalliative).

resultsFrom July 2014 to September 2019, home visits increased by 0.14 (95% CI, 0.05-0.23) visits per 10,000 residents per month. From October 2019 to June 2020, visits decreased by 29.7% (95% CI, 26.0%-33.1%). There was no significant postinterruption trend. Nonpalliative visits decreased more sharply (34.5%) than palliative visits (21.3%).

conclusionsHome visits decreased sharply after incentive reform and the COVID-19 pandemic, with no evidence of recovery except among palliative visits. These findings suggest a structural shift in primary care delivery. Further research should investigate consequences on health outcomes for older adults and optimal models of primary care for older adults with challenges accessing office-based care.

Indexed as

COVID-19Health Care ReformHome Care ServicesHouse CallsPrimary Health CareAccess to Primary CareAgedAged, 80 and overFemaleHumansInterrupted Time Series AnalysisMaleOntarioSARS-CoV-2agedhome visitsprimary health caretime series studies

Identifiers

PMID41587841
PMCPMC12834596

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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.