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密西西比州新冠疫情期间儿科远程心理健康服务的差异及医疗支出影响

Disparities and Medical Expenditure Implications in Pediatric Tele-Mental Health Services During the COVID-19 Pandemic in Mississippi.

作者信息

Zhang Yunxi, Lal Lincy S, Lin Yueh-Yun, Swint J Michael, Zhang Ying, Summers Richard L, Jones Barbara F, Chandra Saurabh, Ladner Mark E

机构信息

Department of Data Science, University of Mississippi Medical Center, Jackson, MS, USA.

Center for Telehealth, University of Mississippi Medical Center, Jackson, MS, USA.

出版信息

J Behav Health Serv Res. 2025 Jan;52(1):109-122. doi: 10.1007/s11414-024-09906-2. Epub 2024 Aug 21.

Abstract

Tele-mental health (TMH) services, including both mental and behavioral healthcare (MBH) services, emerged as a cornerstone in delivering pediatric mental healthcare during the coronavirus disease 2019 (COVID-19) pandemic, yet their utilization and effects on healthcare resource utilization (HCRU) and medical expenditures remain unclear. To bridge the gap, this study aims to investigate the association between TMH utilization and sociodemographic factors and assess its associated HCRU and medical expenditures within a pediatric population in Mississippi. Studying 1,972 insured pediatric patients who accessed outpatient MBH services at the study institution between January 2020 and June 2023, age, race, insurance type, rural residency, and household income were identified as key determinants of TMH utilization. Adjusting for sociodemographics, TMH utilization was associated with 122% more MBH-associated outpatient visits and 36% higher related medical expenditures, but 27% less overall medical expenditures. This study reveals sociodemographic disparities in pediatric TMH utilization, highlights its role in augmenting outpatient mental healthcare access, and shows its potential for cost savings. Future efforts should aim at fostering more digitally inclusive, equitable, and affordable pediatric mental healthcare services.

摘要

远程心理健康(TMH)服务,包括心理和行为医疗保健(MBH)服务,在2019年冠状病毒病(COVID-19)大流行期间成为提供儿科心理健康护理的基石,但其利用率以及对医疗资源利用(HCRU)和医疗支出的影响仍不明确。为了填补这一空白,本研究旨在调查密西西比州儿科人群中TMH利用率与社会人口学因素之间的关联,并评估其相关的HCRU和医疗支出。研究了2020年1月至2023年6月期间在研究机构接受门诊MBH服务的1972名参保儿科患者,年龄、种族、保险类型、农村居住情况和家庭收入被确定为TMH利用率的关键决定因素。在调整社会人口学因素后,TMH利用率与MBH相关的门诊就诊次数多122%以及相关医疗支出高36%相关,但总体医疗支出少27%。本研究揭示了儿科TMH利用率方面的社会人口学差异,突出了其在增加门诊心理健康护理可及性方面的作用,并显示了其节省成本的潜力。未来的努力应旨在促进更具数字包容性、公平性和可承受性的儿科心理健康护理服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ced3/11685237/957208eb2561/11414_2024_9906_Fig1_HTML.jpg

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