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COVID-19 期间快速开展远程精神病学服务:全美最大医疗系统的就诊量增加。

Rapid Telepsychiatry Implementation During COVID-19: Increased Attendance at the Largest Health System in the United States.

机构信息

Office of Behavioral Health (Avalone, Barron, King, Linn-Walton, Freeman, Fattal), Office of Population Health (Lau), Gotham Health, Gouverneur (McQuistion), Jacobi Hospital (Popiel), North Central Bronx Hospital (Popiel), and Bellevue Hospital (Balasubramaniam), NYC Health + Hospitals, New York City; Grossman School of Medicine, New York University, New York City (McQuistion, Balasubramaniam, Fattal).

出版信息

Psychiatr Serv. 2021 Jun;72(6):708-711. doi: 10.1176/appi.ps.202000574. Epub 2021 Mar 18.

Abstract

OBJECTIVE

This study aimed to examine differences in completion rates between telepsychiatry and in-person visits during the COVID-19 pandemic and a prior reference period.

METHODS

The authors used electronic medical record data along with chi-squared or t tests to compare patients' demographic characteristics. Generalized estimating equations for estimating the odds of primary and secondary outcomes were used, controlling for demographic characteristics.

RESULTS

During COVID-19, the odds of completing a telepsychiatry visit (N=26,715) were 6.68 times the odds of completing an in-person visit (N=11,094). The odds of completing a telepsychiatry visit during COVID-19 were 3.00 times the odds of completing an in-person visit during the pre-COVID-19 reference period (N=40,318).

CONCLUSIONS

In this cross-sectional study, outpatient adult mental health clinic telepsychiatry appointments, largely by telephone, were strongly associated with a higher rate of visit completion compared with in-person visits during and prior to the COVID-19 pandemic. Regulators should consider permanently enabling reimbursement for telephone-only telepsychiatry visits.

摘要

目的

本研究旨在考察在 COVID-19 大流行期间和之前的参照期内,远程精神病学就诊和面对面就诊的完成率差异。

方法

作者使用电子病历数据,并结合卡方检验或 t 检验比较患者的人口统计学特征。使用广义估计方程来估计主要和次要结局的可能性,同时控制人口统计学特征。

结果

在 COVID-19 期间,完成远程精神病学就诊(N=26715)的可能性是完成面对面就诊(N=11094)的 6.68 倍。在 COVID-19 期间,完成远程精神病学就诊的可能性是完成 COVID-19 之前参照期内面对面就诊的可能性的 3.00 倍(N=40318)。

结论

在这项横断面研究中,与面对面就诊相比,门诊成人心理健康诊所的远程精神病学预约(主要通过电话)与就诊完成率的提高密切相关,无论是在 COVID-19 大流行期间还是之前。监管机构应考虑永久性地为仅通过电话进行的远程精神病学就诊提供报销。

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