Primary care home visits for older adults declined after payment policy changes and COVID-19 in Ontario, Canada

Impact of incentive reform and COVID-19 on primary care home visits in Ontario: A population-based interrupted time series analysis

2026-01-26

(Press-News.org) Original Research

Primary Care Home Visits for Older Adults Declined After Payment Policy Changes and COVID-19 in Ontario, Canada

Background: In Ontario, primary care home visits, which help older adults who are homebound or have difficulty getting to a clinic, increased during the 2010s but declined after a 2019 policy change reduced payment incentives and the COVID-19 pandemic began. This study examined how primary care home visits for adults aged 65 years and older changed from 2014 to 2024.

What They Found: Researchers used population-level health administrative data and an interrupted time series analysis of monthly home visit rates for Ontario residents aged 65 years and older. Home visits increased slightly before 2019 but dropped sharply by nearly 30 percent during the period from October 2019 through June 2020, which included the incentive change and early COVID-19 disruptions. Visit rates did not recover through 2024 and remained about one-third lower than expected. Nonpalliative home visits (routine primary care not focused on end-of-life care) declined more than palliative home visits, which were the only type to show growth after 2020.

Implications: Primary care home visits for older adults declined substantially and did not rebound after policy changes and COVID-19, suggesting a lasting shift in how care is delivered. Impact of Incentive Reform and COVID-19 on Primary Care Home Visits in Ontario: A Population-Based Interrupted Time Series Analysis

Aaron Jones, PhD, et al

Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada

ICES, Toronto, Ontario, Canada

Centre for Integrated Care, St Joseph’s Health System, Hamilton, Ontario, Canada

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