Evidence map›Paper›PMID 39774523›Full record

ArticlePloS one2025

Use of virtual care near the end of life before and during the COVID-19 pandemic: A population-based cohort study.

Kieran L Quinn, Thérèse A Stukel, Allan Detsky, Hannah Chung, Mohammed Rashidul Anwar, Sacha Bhatia, James Downar, Vivian Hung, Sarina Isenberg, Allison Kurahashi and 4 more

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In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Kieran L QuinnDepartment of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-1681-5170
Thérèse A StukelICES, Toronto and Ottawa, ON, Canada.
Allan DetskyDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Hannah ChungICES, Toronto and Ottawa, ON, Canada.
Mohammed Rashidul AnwarInsitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Sacha BhatiaDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
James DownarDivision of Palliative Care, Dept of Medicine, University of Ottawa, Ottawa, ON, Canada.
Vivian HungTemmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada.
Sarina IsenbergDivision of Palliative Care, Dept of Medicine, University of Ottawa, Ottawa, ON, Canada.
Allison KurahashiTemmy Latner Centre for Palliative Care, Sinai Health System, Toronto, ON, Canada.
Douglas S LeeDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Nathan StallDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Peter TanuseputroICES, Toronto and Ottawa, ON, Canada.
Chaim M BellDepartment of Medicine, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe expanded use of virtual care may worsen pre-existing disparities in use and delivery of end-of-life care among certain groups of people. We measured the use of virtual care in the last three months of life before and after the introduction of virtual care fee codes that funded care delivery at the start of COVID-19 on March 14, 2020, and identified changes in the characteristics of people using it.

methodsWe used linked clinical and administrative datasets to study use of virtual care in the last three months of life among 411,564 adults who died between January 25, 2018, and November 30, 2022. Modified Poisson regression was used to measure the association of the use of virtual care in the last three months of life with the pandemic study period and its association with each person- and physician-level factor.

results14,261 people (8%) used virtual care in the last three months of life before the pandemic, and 161,000 people (69%) used it during the pandemic (relative risk [RR] 8.76; 95% CI 8.48-9.05). Several individual patient characteristics were associated with statistically significant increases in the use of virtual care after March 14, 2020 (following the introduction of virtual care fee codes), compared to before such as among older adults, ethnic minorities, multiple chronic comorbid health conditions and higher frailty groups.

conclusionsThe introduction of new fee codes broadening technology and funding for end-of-life care at the start of pandemic combined with pandemic-related effects was associated with a substantial increase in the use of virtual care near the end of life among certain groups and a general leveling of pre-existing disparities in its use. Virtual end-of-life care delivery may strengthen person-centredness for individuals with limited ability to attend in-person appointments and by providers who may not have previously engaged in such care.

Indexed as

COVID-19TelemedicineTerminal CareAdolescentAdultAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedPandemicsSARS-CoV-2Young Adult

Identifiers

PMID39774523
PMCPMC11709317

What Socratic holds

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LicenceCC BY
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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 Socratic graph.