COVID-19 Telehealth Policies' Impact on Provision of Alcohol and Substance Use Disorder Services at Federally Qualified Health Centers

COVID-19 远程医疗政策对联邦合格健康中心提供酒精和药物滥用障碍服务的影响

• 批准号: 10662155
• 负责人: Mary Kristina Wharton
• 金额: $ 22.55万
• 依托单位: PACIFIC INSTITUTE FOR RES AND EVALUATION
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-10 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10662155
• 关键词: Address; Adoption; Agricultural Workers; Alcohol consumption; American; Annual Reports; Behavior Therapy; COVID-19; COVID-19 pandemic; Caring; Categories; Characteristics; Coronavirus; Data; Data Analyses; Data Collection; Economics; Enrollment; Essential worker; Evaluation; Family; Federally Qualified Health Center; Funding; Goals; Health Policy; Health Services; Health Services Accessibility; Health system; Healthcare; Homelessness; Improve Access; Individual; Information Systems; Insurance Coverage; Intervention; Knowledge; Legal; Low income; Measures; Medicaid; Mental Health Services; Methods; Migrant; Mission; Modeling; Morbidity - disease rate; National Institute of Drug Abuse; National Institute on Alcohol Abuse and Alcoholism; Natural experiment; Outcome; Patients; Persons; Policies; Policy Analysis; Population; Population Characteristics; Primary Care; Provider; Public Housing; Reporting; Research; Resources; Safety; Seasons; Security; Series; Service provision; Services; Special Population; Statutes and Laws; Stress; Substance Use Disorder; Technology; Underserved Population; Unemployment; United States; United States Health Resources and Services Administration; Variant; Virus; Visit; Woman; alcohol use disorder; analytical method; barrier to care; connected health; health care delivery; health inequalities; improved; innovation; medically underserved; medically underserved population; medication-assisted treatment; mortality; new pandemic; pandemic disease; patient oriented; patient population; people of color; post-pandemic; pre-pandemic; prevent; programs; response; rural area; service utilization; societal costs; substance use; substance use treatment; telehealth; underserved community

ABSTRACT In the United States, alcohol and substance use disorders (AUD and SUD) are highly prevalent and are established causes of mortality, morbidity, individual and societal costs. There is significant unmet need in accessible AUD and SUD treatment options, however telehealth is demonstrated to be an effective solution to addressing barriers to treatment, especially for underserved populations. The COVID-19 pandemic necessitated a rapid pivot to telehealth by adapting available technologies and deregulating telehealth use as a replacement to in-person services. Adoption of telehealth for AUD and SUD treatment may be particularly advantageous for addressing issues of access for medically underserved populations, such as those served by Federally Qualified Health Centers (FQHCs). Results will identify telehealth policies (i.e., Audio-only Telehealth, Provider Type Expansion, Service Type Expansion) that were effective during the pandemic to inform lasting changes to health systems improving access to AUD and SUD services. The central hypothesis is that policies supporting telehealth during COVID-19 will be positively associated with increased AUD and SUD service utilization in underserved populations. Our specific aims are as follows: 1. Conduct legal analysis of state Medicaid COVID- 19 telehealth policies; 2. Evaluate state Medicaid telehealth policies on AUD and SUD service utilization at FQHCs, and 3. Analyze impact of state Medicaid COVID-19 telehealth policies on FQHC special populations. The study will employ the Center for Connected Health Policy's Policy Finder resource for COVID-19 telehealth policy data and FQHC program data for outcome data on patient characteristics (e.g., demographic information) and services provided (e.g., number of visits and number of patients for AUD and SUD services). We will conduct a series of differences-in-differences models and use other analytic methods using longitudinal data to compare categorized telehealth policies developed through legal research on state Medicaid telehealth policies. The aims of the proposed study are inherently innovative as the telehealth policy changes resulting from the COVID-19 pandemic are novel and present a unique opportunity to evaluate the impact of telehealth on AUD and SUD access and utilization, particularly for underserved populations. Identifying policies that improve access to AUD and SUD care and treatment will have lasting and significant implications for health services after the pandemic, such as permanent policy adoption or application to different payors, settings, and populations.

摘要 在美国，酒精和物质使用障碍(AUD和SUD)非常普遍，而且 已确定的死亡率、发病率、个人和社会成本的原因。有大量未得到满足的需求 可获得AUD和SUD治疗选项，但远程医疗已被证明是一种有效的解决方案 解决治疗障碍，特别是对服务不足的人群。新冠肺炎大流行使得 通过采用现有技术和放松对远程医疗使用的监管来快速转向远程医疗 到面对面的服务。采用远程医疗进行AUD和SUD治疗可能特别有利于 解决医疗服务不足人群的准入问题，例如由联邦合格人员提供服务的人群 健康中心(FQHC)。结果将确定远程医疗策略(即纯音频远程医疗、提供商类型 扩展、服务类型扩展)，在大流行期间有效地通知健康的持久变化 改善AUD和SUD服务获取的系统。中心假设是支持的政策 新冠肺炎期间的远程医疗将与#年澳元和南德服务利用率的增加呈正相关 服务不足的人群。我们的具体目标如下：1.对州医疗补助COVID进行法律分析- 19项远程医疗政策；2.评估有关澳大利亚和南部地区服务利用率的州医疗补助远程医疗政策，请访问 分析国家医疗补助新冠肺炎远程医疗政策对计划生育特殊人群的影响。 这项研究将利用互联医疗政策中心的政策查找器资源来实现新冠肺炎远程医疗 有关患者特征的结果数据(例如，人口统计信息)的政策数据和FQHC计划数据 和提供的服务(例如，AUD和SUD服务的就诊次数和患者数量)。我们将进行 一系列差异模型，并使用其他分析方法使用纵向数据进行比较 通过对州医疗补助远程医疗政策的法律研究制定的远程医疗政策分类。目标 随着新冠肺炎带来的远程医疗政策变化，拟议研究的许多内容都具有内在的创新性 大流行是新的，并提供了一个独特的机会来评估远程医疗对澳大利亚和南部地区的影响 获取和利用，特别是对服务不足的人群。确定改善澳元使用情况的政策 疫情过后对卫生服务的影响将是持久而重大的， 例如对不同付款人、环境和人口采用或应用永久保单。