Primary care for older adults with functional impairment: the role of home visits after the shift to virtual care

Background As Canada's population gets older, more Canadians are having trouble getting to their family doctor's office. In the last decade, there was a large increase in the number of doctors visiting patients in their homes. But the COVID-19 pandemic led to a surge in virtual care, replacing many in-person visits. While virtual care can also help people who can't go to the office, it might not be the best option for older adults with complex health needs. We need study home visits and virtual visits to find the best way to provide primary care for seniors who have trouble going to the doctor's office. Objectives: 1.Explore how frequently doctors made home visits in Ontario before, during, and after the COVID-19 pandemic 2.Compare how well home visits and virtual visits prevent future visits to the emergency room and hospital admissions in patients who have limited mobility. 3.Understand the experiences that older adults living with limited mobility have with virtual care and home visits. Methods: We will use a mix of research methods. We'll look at health data for the whole population in Ontario, studying how often doctors made home visits from 2014 to 2023, especially during and after the COVID-19 pandemic. Additionally, we'll conduct a study comparing the health service use of older adults following home visits and virtual visits. Lastly, we'll interview older adults with limited mobility to understand their experiences and preferences with virtual care and home visits. Expected Outcomes: Our research will give us important insights into the current use of home visits in Ontario and how they were impacted by the pandemic. We will learn how effective home visits are compared to virtual visits, providing valuable information for health system policies. Knowing how patients feel about receiving care in-person at home versus online will help us us improve the both healthcare system and individual care plans for seniors with limited mobility.