Jane M. Zhu (
Renae Myers, Oregon Health & Science University and Portland State University, Portland, Oregon.
Health Aff (Millwood). 2022 Apr;41(4):573-580. doi: 10.1377/hlthaff.2021.01297.
The COVID-19 pandemic disrupted mental health services delivery across the US, but the extent and implications of these disruptions are unclear. This retrospective observational analysis used the claims clearinghouse Office Ally to compare outpatient mental health services use from March to December 2016-18 against use during the same period in 2020. We identified encounters for people ages twelve and older with primary diagnosis codes corresponding to mental health conditions and categorized encounters as in-person or telehealth, using Current Procedural Terminology and place-of-service codes. In-person mental health encounters were reduced by half in the early months of the pandemic, with rapid recovery of service delivery attributable to telehealth uptake (accounting for 47.9 percent of average monthly encounters). We found variation in the degree to which telehealth use increased across groups: People with schizophrenia made up a lower proportion of telehealth encounters relative to in-person visits (1.7 percent versus 2.7 percent), whereas those with anxiety and fear-related disorders accounted for a higher proportion (27.5 percent versus 25.5 percent). These findings highlight the importance of broadening access to services through new modalities without supplanting necessary in-person care for certain groups.
新冠疫情大流行扰乱了美国各地的精神卫生服务提供，但这些干扰的程度和影响尚不清楚。本回顾性观察分析使用理赔交换中心 Office Ally 将 2016-18 年 3 月至 12 月期间和 2020 年同期的门诊精神卫生服务使用情况进行了比较。我们确定了 12 岁及以上人群的就诊记录，其主要诊断代码对应精神健康状况，并使用当前程序术语和服务地点代码将就诊记录分类为面对面或远程医疗。在疫情早期，面对面的精神卫生服务减少了一半，但由于远程医疗的采用，服务提供迅速恢复（占平均每月就诊记录的 47.9%）。我们发现，远程医疗的使用程度在不同群体之间存在差异：精神分裂症患者远程医疗就诊的比例相对较低（1.7%比 2.7%），而焦虑和恐惧相关障碍患者的比例较高（27.5%比 25.5%）。这些发现强调了通过新的模式扩大服务获取渠道的重要性，而不会取代某些群体必要的面对面护理。
