RAND Corporation, Santa Monica, California (Cantor, Hanson), Boston (McBain), Arlington, Virginia (Kofner), and Pittsburgh (Stein); Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston (Yu).
Psychiatr Serv. 2022 Apr 1;73(4):411-417. doi: 10.1176/appi.ps.202100191. Epub 2021 Aug 19.
The study examined temporal and geographic trends in telehealth availability at U.S. behavioral health treatment facilities and risk factors for not offering telehealth.
Longitudinal data on 15,691 outpatient behavioral health treatment facilities were extracted daily from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Services Locator between January 20, 2020, and January 20, 2021. Facilities operated by the Department of Veterans Affairs were excluded. Bivariate analyses were used to assess trends in telehealth availability in 2020 and 2021. Multivariable regression analysis was used to examine facility- and county-level characteristics associated with telehealth availability in 2021.
Telehealth availability increased by 77% from 2020 to 2021 for mental health treatment facilities and by 143% for substance use disorder treatment facilities. By January 2021, 68% of outpatient mental health facilities and 57% of substance use disorder treatment facilities in the sample were offering telehealth. Mental health and substance use disorder treatment facilities that did not accept Medicaid as a form of payment were less likely to offer telehealth in 2021, compared with facilities that accepted Medicaid. Mental health and substance use disorder treatment facilities that accepted private insurance were more likely to offer telehealth in 2021, compared with facilities that did not accept private insurance.
Although 2020 saw a dramatic increase in telehealth availability at behavioral health treatment facilities, 32% of mental health treatment facilities and 43% of substance use disorder treatment facilities did not offer telehealth in January 2021, nearly 1 year into the pandemic.
本研究考察了美国行为健康治疗机构提供远程医疗的时间和地域趋势，以及不提供远程医疗的风险因素。
从 2020 年 1 月 20 日至 2021 年 1 月 20 日，每天从物质滥用和心理健康服务管理局的行为健康治疗服务定位器中提取 15691 家门诊行为健康治疗机构的纵向数据。排除由美国退伍军人事务部运营的机构。采用双变量分析评估 2020 年和 2021 年远程医疗可用性的趋势。多变量回归分析用于研究 2021 年与远程医疗可用性相关的机构和县级特征。
2020 年至 2021 年，精神健康治疗机构的远程医疗可用性增加了 77%，物质使用障碍治疗机构的远程医疗可用性增加了 143%。到 2021 年 1 月，样本中 68%的门诊精神健康设施和 57%的物质使用障碍治疗设施提供远程医疗。与接受医疗补助的机构相比，不接受医疗补助作为支付方式的精神健康和物质使用障碍治疗机构在 2021 年提供远程医疗的可能性较小。与不接受私人保险的机构相比，接受私人保险的精神健康和物质使用障碍治疗机构在 2021 年提供远程医疗的可能性更大。
尽管 2020 年行为健康治疗机构的远程医疗可用性显著增加，但在大流行近 1 年后的 2021 年 1 月，仍有 32%的精神健康治疗机构和 43%的物质使用障碍治疗机构没有提供远程医疗。
