Pediatric primary care in Ontario and Manitoba after the onset of the COVID-19 pandemic: a population-based study

Abstract

Primary health care is essential to maintaining the health of individuals and populations, and the functioning of a health care system. For children in particular, primary care is the cornerstone for monitoring growth and development, providing anticipatory guidance and delivering vaccinations for vaccine-preventable diseases. A good primary care system is associated with more equitable health in populations. 1,2 Delays in or failure to access regular and timely primary care can lead to service gaps during a period of critical development for children and can further widen health inequities.In March 2020, the COVID-19 pandemic was declared by the World Health Organization. 3 Many primary care provider offices closed or functioned at reduced capacity alongside broader shutdowns including nonurgent health care. 4,5 Care providers reported difficulty keeping offices open owing to multiple factors including lack of personal protective equipment and fear of infection. 6 To mitigate the challenges to providing care imposed by the shutdown, and to facilitate and maintain isolation, the Ontario and Manitoba ministries of health introduced new virtual care fee codes. 7 Virtual care is a well-established modality for care delivery, especially for mental health care. Its integration into pediatric primary care for those with a medical home is supported by the American Academy of Pediatrics. 8 For children, however, for whom growth monitoring, vision screening and vaccinations require in-person visits, needed care may only partially be provided virtually. Virtual care may not be optimal for families with lack of access to a reliable Internet or telephone

Migrants’ primary care utilisation before and during the COVID-19 pandemic in England: An interrupted time series analysis

“… 32 , 33 Similarly, disproportionate reductions in primary care during the pandemic have also been reported for migrant children in Ontario, Canada. 34 Focusing on middle adulthood, evidence prior to this study showed that migrant women experience challenges in accessing maternity care in the UK. 35 Gender-stratified analysis based on this a-priori hypothesis should be conducted in future in migrants of child-bearing age.…”

Healthcare Avoidance before and during the COVID-19 Pandemic among Australian Youth: A Longitudinal Study

“…Healthcare seeking between waves and in other states of the country may have continued quite similarly to the years before COVID-19 [ 29 , 51 , 53 ]. Furthermore, similar to other developed countries [ 54 , 55 , 56 ], Australia has provisioned telehealth services during the COVID-19 pandemic [ 30 ], and this might have enabled care seeking to be similar to pre-pandemic [ 29 ]. Other researchers have also studied the issue of healthcare avoidance during COVID-19.…”

Screening for psychosocial risk in caregivers of children with medical complexity during the COVID-19 pandemic: a cross-sectional study

“…This is supported by our finding that ‘Child Problems’, which addresses behavioural, cognitive and social problems that a child may be experiencing,23 was the highest endorsed PAT subscale, and was even higher than Verma et al found. The pandemic led to a suspension of primary care visits, which created gaps in healthcare for CMC 27 28. These visits also provide important opportunities for primary care physicians to monitor behavioural development and offer appropriate interventions.…”

“…As previously mentioned, the COVID-19 pandemic resulted in the decreased provision of home care and supportive care services (eg, physiotherapy, occupational therapy, etc) as well as reduced access to in-person healthcare appointments 3 7 28. In turn, there was likely an increased demand placed on parents to fill in the care gaps created by the suspension of these health services.…”