Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States
Rapid Growth In Mental Health Telemedicine Use Among Rural Medicare Beneficiaries, Wide Variation Across States
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DOI：
10.1377/hlthaff.2016.1461
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发表时间：
2017-05-01
期刊：
影响因子：
9.7
通讯作者：
Busch, Alisa B.
中科院分区：
文献类型：
--
作者：
Mehrotra, Ateev;Huskamp, Haiden A.;Busch, Alisa B.
国会和许多州立法机构正在考虑扩大远程医疗的覆盖范围。为了为这场辩论提供信息，我们分析了 2004-14 年期间的医疗保险按服务收费索赔，以了解远程医疗用于心理健康护理（也称为远程心理健康）的趋势和近期使用情况。研究人群包括被诊断患有任何精神疾病或严重精神疾病的农村受益人。远程精神健康就诊次数年均增长45.1%，到2014年，每100名农村受益人中患有任何精神疾病和严重精神疾病的远程精神健康就诊次数分别为5.3次和11.8次。各州之间存在显着差异：2014 年，有 9 个州每 100 名患有严重精神疾病的受益人就诊次数超过 25 次，而 4 个州和哥伦比亚特区则没有。与其他患有精神疾病的受益人相比，接受远程心理健康访问的受益人更有可能年龄在六十五岁以下，因残疾而有资格享受医疗保险，并且生活在相对贫困的社区。拥有远程医疗平等法和有利于健康监管环境的国家，远程精神医疗的使用率明显高于那些没有远程医疗平等法和支持健康监管环境的国家。
Congress and many state legislatures are considering expanding access to telemedicine. To inform this debate, we analyzed Medicare fee-for-service claims for the period 2004-14 to understand trends in and recent use of telemedicine for mental health care, also known as telemental health. The study population consisted of rural beneficiaries with a diagnosis of any mental illness or serious mental illness. The number of telemental health visits grew on average 45.1 percent annually, and by 2014 there were 5.3 and 11.8 telemental health visits per 100 rural beneficiaries with any mental illness or serious mental illness, respectively. There was notable variation across states: In 2014 nine had more than twenty-five visits per 100 beneficiaries with serious mental illness, while four states and the District of Columbia had none. Compared to other beneficiaries with mental illness, beneficiaries who received a telemental health visit were more likely to be younger than sixty-five, be eligible for Medicare because of disability, and live in a relatively poor community. States with a telemedicine parity law and a pro-telemental health regulatory environment had significantly higher rates of telemental health use than those that did not.