Changes in emergency and primary care use after adding virtual physicians to HealthLink BC's 8-1-1 program

Area of Science:

• Health Services Research
• Telehealth
• Primary Care Access

Background:

• Canada faces significant human resource constraints in healthcare, limiting timely access to primary care (PC).
• This scarcity drives patients to emergency departments (ED) for non-urgent medical needs, increasing healthcare system strain.

Purpose of the Study:

• To evaluate the impact of integrating virtual physicians into HealthLink BC's 8-1-1 telehealth program.
• To assess changes in emergency department and primary care utilization and associated healthcare costs.

Main Methods:

• A time series analysis was conducted using data from 445,630 telehealth users.
• Evaluated were visits to ED and PC within 30 days and healthcare costs before and after the virtual physician intervention.

Main Results:

• The virtual physician intervention led to a significant reduction in ED visits (16.14 fewer per 1000 patients) and an increase in PC visits (106.14 more per 1000 patients) within 30 days.
• Patients over 15 without chronic conditions or existing PC relationships showed higher PC follow-up but also increased patient-paid medical travel costs.
• Overall healthcare system costs remained neutral over a one-year period.

Conclusions:

• Virtual physician integration into telehealth services can effectively divert patients from emergency departments to primary care.
• Long-term health outcomes and patient-borne travel costs are crucial factors for future Canadian health policy evaluations.
• This model offers a potential solution to improve healthcare access and resource allocation within the Canadian context.