Comparative Case Study of the COVID-19 Response for Urban Underserved Patients Experiencing Care Transitions in Three Canadian Cities

Urban underserved populations - communities with lived experience of poverty, unstable housing, and high burden of physical and mental illness and addiction - experience poor care integration (particularly during transitions in care) as well as disproportionate morbidity and premature mortality. Urban underserved populations are at disproportionate risk of experiencing COVID-19 infection/transmission and illness severity, as well as disruption of the usual continuum of care due to the pandemic response.

Our mixed methods comparative case study of three Canadian cities (Edmonton, Winnipeg, Toronto) will document and analyze COVID-19-relevant policies that impact continuity of care, especially during transitions between care spaces. We will examine policy texts (e.g., health authority guidelines, Hansard, media announcements) and key informant interviews (e.g., with urban underserved community members, frontline health workers, system leaders). Our specific objectives are to:

1. Describe COVID-19 response policies specific to urban underserved populations across three provinces

2. Examine how these policies impact continuity of care, in particular during care transitions

3. Determine how urban underserved community members have been engaged in the policy process

4. Co-develop policy and operational recommendations for optimizing continuity of care for urban underserved populations within and across Canada during the pandemic response

Our research will provide pragmatic, timely evidence to inform health system planning and delivery within the current pandemic context for urban underserved Canadians.

Study Lead: Ginetta Salvalaggio

Funding Support: Northern Alberta Clinical Trials & Research Centre (NACTRC) and the Royal Alexandra Hospital Foundation (RAHF)

Status: Ongoing