{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:28:49Z","timestamp":1784874529076,"version":"3.55.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T00:00:00Z","timestamp":1762646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012665","name":"ICES","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012665","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025092","name":"Ontario Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025092","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100025090","name":"Ministry of Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007658","name":"Crohn\u2019s and Colitis Canada","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007658","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Canada Post Corporation"},{"name":"Ontario Ministry of Health Postal Code Conversion File"},{"name":"Canada Post Corporation and Statistics Canada"},{"DOI":"10.13039\/501100025092","name":"Ontario Ministry of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100025092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Access to inflammatory bowel diseases (IBD) specialist care is a predictor of health outcomes. We sought to characterize the impact of the pandemic on patterns of IBD healthcare delivery and whether it compromised overall access to care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified adults with an IBD diagnosis residing in Ontario between 2016 and 2021 using administrative data at ICES. We determined quarterly rates of in-person and virtual IBD specialist visits and stratified that by regions with high and low access to IBD specialists. We stratified our analyses into 3 periods: pre-COVID, immediate COVID, and maintenance COVID. We performed interrupted time series analysis to assess for time trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the immediate COVID phase, there was a 69% relative quarterly decline in in-person IBD specialist visits with a concurrent 591% relative quarterly rise in rates of virtual visits. Entering the COVID maintenance phase, there was a 7% quarterly relative decline in the rate of in-person visits, and a 7% and 4% quarterly relative increases in the rates of virtual and total IBD specialist visits, respectively. Pre-pandemic, IBD patients residing in regions with high specialist access had a 16% higher rate of visits than those in low-access regions. During the COVID maintenance phase, the disparity was reduced to 12%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>During the COVID-19 pandemic, the rapid transition from in-person to virtual IBD specialist care led to a slight increase in overall IBD visits. There was also a small decrease in the gap in rates of IBD specialist visits between high- and low-access regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jcag\/gwaf030","type":"journal-article","created":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T20:15:03Z","timestamp":1762719303000},"page":"24-29","source":"Crossref","is-referenced-by-count":1,"title":["Patterns of specialist healthcare delivery among inflammatory bowel disease patients in response to the COVID-19 pandemic in Ontario: a population-based study"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4391-1563","authenticated-orcid":false,"given":"Luke J","family":"Nguyen","sequence":"first","affiliation":[{"name":"Mount Sinai Centre for Inflammatory Bowel Disease , Toronto, Ontario,","place":["Canada"]},{"name":"Faculty of Health Sciences, Queen\u2019s University , Kingston, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4524-9403","authenticated-orcid":false,"given":"Vivian","family":"Huang","sequence":"additional","affiliation":[{"name":"Mount Sinai Centre for Inflammatory Bowel Disease , Toronto, Ontario,","place":["Canada"]},{"name":"Division of Gastroenterology and Hepatology, University Health Network and Sinai Health System, University of Toronto , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Habashi","sequence":"additional","affiliation":[{"name":"Mount Sinai Centre for Inflammatory Bowel Disease , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiding","family":"Gao","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parul","family":"Tandon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University Health Network and Sinai Health System, University of Toronto , Toronto, Ontario,","place":["Canada"]},{"name":"Institute of Health Policy, Management and Evaluation , Toronto, Ontario,","place":["Canada"]},{"name":"ICES , Toronto, Ontario,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,9]]},"reference":[{"key":"2026020910520186300_gwaf030-B1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1053\/j.gastro.2011.03.050","article-title":"Outcomes of patients with Crohn\u2019s disease improved from 1988 to 2008 and were associated with increased specialist care","volume":"141","author":"Nguyen","year":"2011","journal-title":"Gastroenterology"},{"key":"2026020910520186300_gwaf030-B2","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1093\/ibd\/izad194","article-title":"Racial and ethnic disparities in patients with inflammatory bowel disease: an online survey","volume":"30","author":"Shah","year":"2024","journal-title":"Inflamm Bowel Dis"},{"key":"2026020910520186300_gwaf030-B3","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1093\/ecco-jcc\/jjy161","article-title":"Access to specialists and emergency department visits in inflammatory bowel disease: a population-based study","volume":"13","author":"Nguyen","year":"2019","journal-title":"J Crohns Colitis"},{"key":"2026020910520186300_gwaf030-B4","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/jcag\/gwy046","article-title":"Transforming access to specialist care for inflammatory bowel disease: the PACE telemedicine 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