Lin Brendon, Costakis Anna, John Majnu, Linder Howard
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.
Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, United States.
Front Psychiatry. 2023 Jun 7;14:1172019. doi: 10.3389/fpsyt.2023.1172019. eCollection 2023.
This study examines the quality of care provided through telepsychiatry by comparing psychiatric hospitalization rates among patients receiving in-person psychiatric care prior to the COVID-19 pandemic with rates among patients receiving virtual psychiatric care during the COVID-19 pandemic.
Mental health-related hospitalization rates among patients enrolled in a large academic hospital's outpatient psychiatry programs between March 1, 2018 and February 28, 2022 were retrospectively analyzed. Four time periods were created, spanning March 1 to February 28 of the following year. Demographic and clinical data were collected from the electronic health record, and descriptive statistics were calculated. Change in hospitalization rate between time periods was evaluated using McNemar's test.
In the 2018 time period, 7.38% of all enrolled patients were hospitalized, compared to 7.70% hospitalized in the 2019 period, 5.74% in the 2020 period, and 5.38% in the 2021 period. Patients enrolled in both the 2018 and the 2019 periods saw no difference in hospitalization rate between the 2 years (2.93% in 2018, 2.83% in 2019; = 0.830); patients enrolled in both 2019 and 2020 saw significantly lower hospitalization rates in 2020 (5.47% in 2019, 4.58% in 2020; = 0.022); and patients enrolled in both 2020 and 2021 saw no difference (3.34% in 2020, 3.23% in 2021; = 0.777).
Psychiatric hospitalization rates significantly decreased between the 2019 and the 2020 periods, suggesting a decrease in admissions associated with adoption of telepsychiatry. Future research should differentiate the roles played by telepsychiatry and COVID-19-related factors in reducing hospitalization rates during the pandemic.
本研究通过比较在2019冠状病毒病大流行之前接受面对面精神科护理的患者的精神科住院率与在2019冠状病毒病大流行期间接受虚拟精神科护理的患者的住院率，来检验通过远程精神病学提供的护理质量。
对2018年3月1日至2022年2月28日期间在一家大型学术医院门诊精神科项目登记的患者中与心理健康相关的住院率进行回顾性分析。创建了四个时间段，涵盖从当年3月1日到次年2月28日。从电子健康记录中收集人口统计学和临床数据，并计算描述性统计量。使用麦克尼马尔检验评估不同时间段之间住院率的变化。
在2018年时间段，所有登记患者中有7.38%住院，2019年时间段为7.70%，2020年时间段为5.74%，2021年时间段为5.38%。同时参与2018年和2019年的患者在这两年间住院率没有差异（2018年为2.93%，2019年为2.83%；P = 0.830）；同时参与2019年和2020年的患者在2020年的住院率显著降低（2019年为5.47%，2020年为4.58%；P = 0.022）；同时参与2020年和2021年的患者没有差异（2020年为3.34%，2021年为3.23%；P = 0.777）。
2019年至2020年期间精神科住院率显著下降，表明与采用远程精神病学相关的住院人数减少。未来的研究应区分远程精神病学和与2019冠状病毒病相关的因素在大流行期间降低住院率中所起的作用。
