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Background: Uptake of virtual care increased substantially during the first year of the COVID-19 pandemic. The aim of this study was to evaluate whether a shift from in-person to virtual visits by primary care physicians was associated with increased use of emergency departments among their enrolled patients. Methods: We conducted an observational study of monthly virtual visits and emergency department visits from Apr. 1, 2020, to Mar. 31, 2021, using administrative data from Ontario, Canada. We used multivariable regression analysis to estimate the association between the proportion of a physician’s visits that were delivered virtually and the number of emergency department visits among their enrolled patients. Results: The proportion of virtual visits was higher among female, younger and urban physicians, and the number of emergency department visits was lower among patients of female and urban physicians. In an unadjusted analysis, a 1% increase in a physician’s proportion of

United statesUnited kingdomSteve nastosJames wrightTaylor lougheedJasmin kantarevicShaun shaikhNikolina mizdrakPatrick conlonPaul tenenbeinHemant shahEmergency departmentNational ambulatory care reporting systemOntario ministry of healthClient agency enrolment programOntario medical association