Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic.
Mental health services in primary care: Evidence for the feasibility of telehealth during the COVID-19 pandemic.
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初级保健中的心理健康服务：COVID-19- 19日大流行期间远程医疗可行性的证据。
DOI：
10.1016/j.jadr.2021.100146
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发表时间：
2021-07
影响因子：
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通讯作者：
Wolff J
中科院分区：
文献类型：
--
作者：
Frank HE;Grumbach NM;Conrad SM;Wheeler J;Wolff J
这项研究从就诊率、循证干预措施的提供和临床结果等方面考察了新冠肺炎大流行期间向远程医疗服务的过渡。使用图表回顾数据比较了综合初级保健会议中面对面访问与远程访问的可行性。从一家综合初级诊所收集了患者特征、就诊情况、症状严重程度和改善情况以及循证干预使用的数据，这些患者来自一家综合初级诊所，该诊所主要服务于主要表现为抑郁和焦虑问题的低收入、多样化的成人和儿童样本。在过渡到远程保健后，出席率显著提高，取消的次数减少，参加的预约次数增加。患者的症状有明显改善和减少。随着时间的推移，一致的循证干预措施的使用表明，护理质量得到了保持。这项研究受到以下事实的限制，即它发生在学术上附属的初级保健诊所，可能不能代表所有的社区环境。此外，与临床症状相关的分析只对一小部分参与者进行，没有对照组。通过综合初级保健实现远程保健可能是改善低收入、种族/少数民族成年人和儿童获得心理保健服务的可行选择。
This study examined the transition to telehealth services during the COVID-19 pandemic in terms of attendance rates, the provision of evidence-based interventions, and clinical outcomes. The feasibility of in-person versus telehealth visits for integrated primary care sessions was compared using chart review data. Data on patient characteristics, attendance, symptom severity and improvement, and evidence-based intervention use were collected for patients (N = 173) from an integrated primary clinic that primarily serves a low-income, diverse sample of adults and children whose primary presenting problems are depression and anxiety. Attendance significantly improved after the transition to telehealth, as indicated by fewer cancellations and more appointments attended. Patients showed significant improvement and decreases in symptoms. The quality of care was maintained, as indicated by consistent evidence-based intervention use over time. This study was limited by the fact that it took place in an academically-affiliated primary care clinic, which may not be representative of all community settings. In addition, analyses related to clinical symptoms were only conducted with a small subset of participants and there was no comparison group. Telehealth through integrated primary care might be a viable option to improve accessibility of mental health services for low-income, racial/ethnic minority adults and children.