Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Center for Telehealth, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Int J Environ Res Public Health. 2024 Jun 22;21(7):819. doi: 10.3390/ijerph21070819.
During the COVID-19 pandemic, tele-mental health (TMH) was a viable approach for providing accessible mental and behavioral health (MBH) services. This study examines the sociodemographic disparities in TMH utilization and its effects on healthcare resource utilization (HCRU) and medical expenditures in Mississippi. Utilizing a cohort of 6787 insured adult patients at the University of Mississippi Medical Center and its affiliated sites between January 2020 and June 2023, including 3065 who accessed TMH services, we observed sociodemographic disparities between TMH and non-TMH cohorts. The TMH cohort was more likely to be younger, female, White/Caucasian, using payment methods other than Medicare, Medicaid, or commercial insurers, residing in rural areas, and with higher household income compared to the non-TMH cohort. Adjusting for sociodemographic factors, TMH utilization was associated with a 190% increase in MBH-related outpatient visits, a 17% increase in MBH-related medical expenditures, and a 12% decrease in all-cause medical expenditures (all < 0.001). Among rural residents, TMH utilization was associated with a 205% increase in MBH-related outpatient visits and a 19% decrease in all-cause medical expenditures (both < 0.001). This study underscores the importance of addressing sociodemographic disparities in TMH services to promote equitable healthcare access while reducing overall medical expenditures.
在 COVID-19 大流行期间，远程心理健康（TMH）是提供可及的心理和行为健康（MBH）服务的可行方法。本研究考察了密西西比州 TMH 使用中的社会人口统计学差异及其对医疗资源利用（HCRU）和医疗支出的影响。利用 2020 年 1 月至 2023 年 6 月期间在密西西比大学医学中心及其附属机构的 6787 名参保成年患者队列，包括 3065 名使用 TMH 服务的患者，我们观察到 TMH 和非 TMH 队列之间存在社会人口统计学差异。TMH 队列中，年龄较小、女性、白人/高加索人、使用除医疗保险、医疗补助或商业保险公司以外的支付方式、居住在农村地区和家庭收入较高的患者比例较高，而非 TMH 队列则相反。在调整社会人口统计学因素后，TMH 的使用与 MBH 相关的门诊就诊次数增加了 190%，MBH 相关医疗支出增加了 17%，所有原因的医疗支出减少了 12%（均<0.001）。在农村居民中，TMH 的使用与 MBH 相关的门诊就诊次数增加了 205%，所有原因的医疗支出减少了 19%（均<0.001）。本研究强调了在 TMH 服务中解决社会人口统计学差异的重要性，以促进公平的医疗保健获取，同时降低总体医疗支出。
