Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration.
J Prim Care Community Health
; 13: 21501319221091430, 2022.
Article
in English
| MEDLINE | ID: covidwho-1794055
ABSTRACT
INTRODUCTION:
Same-day referrals from primary care to mental health increase subsequent mental health treatment engagement. VA Primary Care-Mental Health Integration (PC-MHI) clinics offer integrated mental health services embedded in primary care clinics, providing a key entry point to mental health care. Although telehealth use expanded rapidly after the onset of COVID-19, the impact of telehealth on same-day primary care access among new PC-MHI mental health patients is unknown. To address this knowledge gap, we examined associations between telehealth use and same-day primary care access in VA PC-MHI.METHODS:
We examined electronic health record data to identify same-day primary care appointments among PC-MHI patients who initiated care during 3/1/2018 to 10/29/2021. We used logistic regression analyses to evaluate the effect of telehealth on same-day primary care access. Time, demographic characteristics, mental health diagnoses (PTSD and depression), and substance use disorder diagnosis were evaluated as covariates.RESULTS:
New PC-MHI patients who were seen via telehealth were less likely to receive same-day primary care access than patients seen in person (OR 0.54; 95% CI 0.41-0.71; P < .001).CONCLUSIONS:
Despite the potential advantages of using telehealth to increase access, VA patients with an initial PC-MHI visit via telehealth were less likely than patients seen in person to be referred from primary care. Telehealth may adversely affect primary care referrals to mental health services, an outcome that could ultimately reduce specialty mental health care continuity. There is an urgent need to identify strategies to facilitate PC-MHI care coordination in the telehealth context.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Telemedicine
/
Delivery of Health Care, Integrated
/
COVID-19
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
J Prim Care Community Health
Year:
2022
Document Type:
Article
Affiliation country:
21501319221091430
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