Cargando…

Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration

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 healt...

Descripción completa

Detalles Bibliográficos
Autores principales: Haderlein, Taona P., Dobalian, Aram, Raja, Pushpa V., Der-Martirosian, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016585/
https://www.ncbi.nlm.nih.gov/pubmed/35426344
http://dx.doi.org/10.1177/21501319221091430
_version_ 1784688560219095040
author Haderlein, Taona P.
Dobalian, Aram
Raja, Pushpa V.
Der-Martirosian, Claudia
author_facet Haderlein, Taona P.
Dobalian, Aram
Raja, Pushpa V.
Der-Martirosian, Claudia
author_sort Haderlein, Taona P.
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9016585
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-90165852022-04-20 Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration Haderlein, Taona P. Dobalian, Aram Raja, Pushpa V. Der-Martirosian, Claudia J Prim Care Community Health Original Research 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. SAGE Publications 2022-04-15 /pmc/articles/PMC9016585/ /pubmed/35426344 http://dx.doi.org/10.1177/21501319221091430 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research
Haderlein, Taona P.
Dobalian, Aram
Raja, Pushpa V.
Der-Martirosian, Claudia
Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title_full Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title_fullStr Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title_full_unstemmed Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title_short Association Between Virtual Care Use and Same-Day Primary Care Access in VA Primary Care-Mental Health Integration
title_sort association between virtual care use and same-day primary care access in va primary care-mental health integration
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9016585/
https://www.ncbi.nlm.nih.gov/pubmed/35426344
http://dx.doi.org/10.1177/21501319221091430
work_keys_str_mv AT haderleintaonap associationbetweenvirtualcareuseandsamedayprimarycareaccessinvaprimarycarementalhealthintegration
AT dobalianaram associationbetweenvirtualcareuseandsamedayprimarycareaccessinvaprimarycarementalhealthintegration
AT rajapushpav associationbetweenvirtualcareuseandsamedayprimarycareaccessinvaprimarycarementalhealthintegration
AT dermartirosianclaudia associationbetweenvirtualcareuseandsamedayprimarycareaccessinvaprimarycarementalhealthintegration