Comparing Value of In-Person and Telemedicine Care for Adults with Acute Health Issues in Emergency, Walk-in, and Primary Care Settings

What this Trial Is About

Researchers are evaluating the value of care received by ambulatory adult patients with acute health concerns such as sore throat, cough, fever, and limb injuries. The study compares care in emergency departments EDs, walk-in clinics WICs, and primary care physician PCP practices, including telemedicine visits, to understand which setting offers the best patient outcomes and cost-effectiveness. This observational research involves multiple centers in Quebec and Ontario and addresses the impact of telemedicine adoption during the COVID-19 pandemic. Participants will receive care either in an ED by physicians unfamiliar with them, in walk-in clinics via in-person or virtual visits, or in primary care clinics where they may see their own or a colleague physician. The study uses a time-driven activity-based costing method to calculate care episode costs, followed by monitoring patients through follow-up phone calls conducted 1-3 days and 8-14 days after the initial visit. These calls gather data on patient experience, outcomes, and costs. During the study, patient data are collected from medical records, provincial databases, and follow-up questionnaires. Researchers will measure patient-reported outcome scores seven days after the visit as the primary outcome, along with experience scores, return visit rates, healthcare costs, hospital admissions, and adherence to care guidelines. The study includes safety monitoring up to 30 days post-visit and aims to help policymakers and providers decide on the most appropriate care setting for ambulatory emergency conditions. The total participation involves at least two follow-up calls after the initial consultation.

The Right Care, for the Right Patient, at the Right Time, by the Right Provider: A Value-based Comparison of the Management of Ambulatory Patients With Acute Health Concerns in walk-in Clinics, Primary Care Physician Practices and Emergency Departments