美国心理远程医疗服务的可用性
Jonathan Cantor1, Megan S Schuler2, Samantha Matthews1
1RAND Corporation, Santa Monica, California.
JAMA health forum
|February 2, 2024
概括
心理健康的远程医疗广泛可用,但因设施和地点而异. 获得药物管理和诊断等特定服务的情况不同,这表明美国在获得心理健康服务方面存在差异.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 心理健康服务 心理健康服务
- 远程医疗远程医疗
背景情况:
- 心理健康护理的远程医疗利用在COVID-19流行后显著增加.
- 然而,这些服务的可用性可能因设施,地理位置,患者人口统计和特定心理健康状况而异.
研究的目的:
- 评估美国各地对主要抑郁症,一般焦虑症和精神分裂症的远程医疗的可用性,等待时间和服务特性.
- 识别与远程医疗可用性相关的设施,客户和县级特征.
主要方法:
- 一项横截面分析涉及到2022年12月至2023年3月期间在美国 (不包括夏威夷) 的1404个心理健康治疗机构 (MHTF) 进行秘密购物调查.
- 收集了关于远程医疗服务的可用性 (行为治疗,药物管理,诊断服务) 和预约等待时间的数据.
- 多变量后勤和线性回归分析检查了设施,客户和县特征与远程医疗可用性之间的关联.
主要成果:
- 在接受新患者的设施中,80%提供远程医疗,97%提供咨询,77%提供药物管理和69%提供诊断服务. 可用性没有根据临床状况而有所不同.
- 私营营利和私营非营利机构更有可能提供远程医疗,而不是公共设施.
- 与非大都会设施相比,大都会设施更有可能提供药物管理,但不太可能提供诊断服务. 第一次远程医疗预约的平均等待时间为14天. 根据患者的种族,种族或性别,没有发现可用性差异.
结论:
- 虽然心理健康服务的远程医疗可用性没有根据临床状况或感知到的患者人口统计学而有所不同,但在设施,县和州层面存在显著差异.
- 这些发现凸显了美国各地获得特定远程医疗服务的潜在差异.
- 需要进一步的研究来解决这些获取差距,并确保提供公平的精神卫生保健服务.
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