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远程精神病学在 COVID-19 大流行期间及之前在参加医疗补助计划的儿童中的使用情况。

Telepsychiatry Use Before and During the COVID-19 Pandemic Among Children Enrolled in Medicaid.

机构信息

Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C.

出版信息

Psychiatr Serv. 2023 Jun 1;74(6):644-647. doi: 10.1176/appi.ps.20220378. Epub 2022 Nov 29.

Abstract

OBJECTIVE

This study examined telepsychiatry use among children enrolled in Medicaid before and during the COVID-19 pandemic.

METHODS

A retrospective analysis was conducted of claims data from the Transformed Medicaid Statistical Information System for children (ages 3-17) with any mental health service use in 2019 (N=5,606,555) and 2020 (N=5,094,446).

RESULTS

The number of children using mental health services declined by 9.1% from 2019 to 2020. Mental health services in all care settings (inpatient, outpatient, residential, emergency department, intensive outpatient/partial hospitalization) declined except for telehealth, which increased by 829.6%. In 2020, 44.5% of children using telehealth were non-Hispanic White, 16.1% were non-Hispanic Black, and 19.7% were Hispanic. Attention-deficit hyperactivity disorder, trauma, anxiety, depression, and behavior/conduct disorder were the most prevalent psychiatric diagnoses among children using telehealth services.

CONCLUSIONS

Although telehealth use increased substantially in 2020, overall mental health service use declined among Medicaid-enrolled children. Telehealth may not fully address unmet mental health service needs.

摘要

目的

本研究调查了 COVID-19 大流行前后参加医疗补助计划的儿童使用远程精神病学的情况。

方法

对 2019 年(N=5606555)和 2020 年(N=5094446)有任何心理健康服务使用记录的儿童(年龄 3-17 岁)的 Transformed Medicaid 统计信息系统索赔数据进行回顾性分析。

结果

与 2019 年相比,2020 年使用心理健康服务的儿童数量下降了 9.1%。除远程医疗外,所有护理环境(住院、门诊、住院、急诊、强化门诊/部分住院)的心理健康服务均有所下降,远程医疗增加了 829.6%。2020 年,使用远程医疗的儿童中,44.5%是非西班牙裔白人,16.1%是非西班牙裔黑人,19.7%是西班牙裔。注意缺陷多动障碍、创伤、焦虑、抑郁和行为/品行障碍是使用远程医疗服务的儿童中最常见的精神科诊断。

结论

尽管 2020 年远程医疗的使用大幅增加,但参加医疗补助计划的儿童的整体心理健康服务使用量下降。远程医疗可能无法完全满足未满足的心理健康服务需求。

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