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