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新冠疫情期间,初级保健中综合心理服务的远程医疗使用的人口统计学预测因素。

Demographic Predictors of Telehealth Use for Integrated Psychological Services in Primary Care During the COVID-19 Pandemic.

机构信息

General Internal Medicine, Henry Ford Health, 2799 W Grand Blvd, K15, Detroit, MI, 48202, USA.

Behavioral Health, Henry Ford Health, One Ford Place, Detroit, MI, 48202, USA.

出版信息

J Racial Ethn Health Disparities. 2023 Jun;10(3):1492-1498. doi: 10.1007/s40615-022-01334-2. Epub 2022 Jul 6.

Abstract

OBJECTIVE

Prior to the COVID-19 pandemic, growing mental health needs were well documented, particularly those of diverse patient populations. The current study aims to better understand racial and psychosocial factors associated with patient utilization of integrated psychological services via telehealth during the COVID-19 pandemic within a diverse primary care clinic.

METHODS

Retrospective chart reviews were completed for patients seen by an integrated psychology team within a general internal medicine clinic at a large urban health system during the year 2020. Demographics were extracted from the medical record. Multivariate logistic regression analyses were conducted to examine demographic predictors for (1) telehealth video visits vs. audio only telehealth visits and (2) in-person vs. telehealth visits (both video and audio).

RESULTS

Older patients, Black patients, and those with Medicare and Medicaid were more likely to complete audio only telehealth visits vs. video visits. There were no significant demographic predictors when comparing in-person vs. telehealth (both video and audio).

DISCUSSION

Some underserved and vulnerable patient populations are more likely to utilize audio-only integrated psychological visits to video visits. The utilization of audio visits over video for certain demographics speaks to the need to better understand how this type of care may benefit psychological services in the future and continued advocacy to extend audio mental health visits beyond the public health emergency to address patient populations with significant mental health needs.

摘要

目的

在 COVID-19 大流行之前,越来越多的心理健康需求得到了充分记录,特别是多样化患者群体的需求。本研究旨在更好地了解与 COVID-19 大流行期间通过远程医疗使用综合心理服务相关的种族和社会心理因素,该研究在一个多样化的初级保健诊所中进行。

方法

对 2020 年期间在大型城市卫生系统的一般内科诊所接受综合心理团队治疗的患者进行回顾性图表审查。从病历中提取人口统计学信息。进行多变量逻辑回归分析,以检查人口统计学预测因素(1)视频远程医疗访问与仅音频远程医疗访问,(2)面对面访问与远程医疗访问(包括视频和音频)。

结果

较年长的患者、黑人患者以及有医疗保险和医疗补助的患者更有可能完成仅音频远程医疗访问,而不是视频访问。在面对面访问与远程医疗访问(包括视频和音频)的比较中,没有显著的人口统计学预测因素。

讨论

一些服务不足和弱势患者群体更有可能利用音频集成心理访问而不是视频访问。某些人群更倾向于使用音频访问而不是视频访问,这表明需要更好地了解这种护理方式如何在未来为心理服务带来益处,并继续倡导将音频心理健康访问延长到公共卫生紧急情况之外,以满足有重大心理健康需求的患者群体。

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