How much carbon dioxide emissions and patient travel–related costs were reduced by the expansion of virtual care during the initial 22 months of the COVID-19 pandemic in Ontario, Canada?
In this cross-sectional study of more than 10 million patients and 63 million virtual care visits, virtual care was associated with avoidance of 3.2 billion km of patient travel, 545 to 658 million kg of carbon dioxide emissions, and $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit.
Findings of this study suggest that these environmental and financial benefits may continue as virtual care is maintained as part of the health care system.
There is a growing focus on environmental sustainability in health care.
To estimate the environmental and patient-level financial benefits associated with the widespread adoption of virtual care during the COVID-19 pandemic.
Design, Setting, and Participants
This population-based cross-sectional study obtained data from linked administrative databases in the universal health care system of Ontario, Canada, from March 2020 to December 2021. Participants included all people with a physician claim for at least 1 episode of virtual care.
Patients were stratified by age, socioeconomic status quintiles, Charlson Comorbidity Index, and area of residence (rural or urban).
Main Outcomes and Measures
The primary outcomes were total travel distance and estimated travel-related carbon dioxide emissions avoided owing to virtual care visits. Different model assumptions were used to account for electric and hybrid vehicles and public transit use. The secondary outcomes were estimated patient costs (gasoline, parking, or public transit expenses) avoided.
During the 22-month study period, 10 146 843 patients (mean [SD] age, 44.1 [23.1] years; 5 536 611 women [54.6%]) had 63 758 914 physician virtual care visits. These visits were associated with avoidance of 3.2 billion km of travel distance and between 545 and 658 million kg of carbon dioxide emissions. Patients avoided an estimated total of $569 to $733 million (Canadian [US $465-$599 million]) in parking, public transit, and gasoline costs. Carbon dioxide emission avoidance and patient cost savings were more apparent in patients living in rural areas, those with higher comorbidity, and those who were older than 65 years.
Conclusions and Relevance
Results of this study suggest that virtual care was associated with a large amount of carbon dioxide emissions avoided owing to reduced patient travel and with millions of dollars saved in parking, gasoline, or public transit costs. These benefits are likely to continue as virtual care is maintained as part of the health care system.