Telehealth in the Treatment of Alcohol Use Disorders: Impact on Access, Disparities, and Quality of Care
远程医疗治疗酒精使用障碍:对服务获取、差异和护理质量的影响
基本信息
- 批准号:10562519
- 负责人:
- 金额:$ 77.77万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-05-15 至 2027-04-30
- 项目状态:未结题
- 来源:
- 关键词:AddressAdultAlcohol consumptionAlcoholsAmbulatory CareBehavior TherapyCOVID-19 pandemicCardiovascular DiseasesCaringCessation of lifeCharacteristicsCirrhosisClinicalCommunitiesCongressesDataDiffuseDimensionsDisparityDisparity populationEmergency department visitEquityEthnic OriginEvaluationExplosionHealthHealth Services AccessibilityImprove AccessIndividualInjuryInsurance CarriersInterviewKnowledgeMalignant NeoplasmsMedicaidMedicareMental DepressionMental Health ServicesMethodsMinorityModalityMorbidity - disease rateOutcomeOutpatientsPatient-Focused OutcomesPatientsPatternPatterns of CarePerceptionPersonsPharmaceutical PreparationsPharmacological TreatmentPoliciesPopulationPrivatizationProviderPsychotherapyQuality of CareRaceRecoveryRecovery SupportRegulationRiskRoleRuralServicesSeveritiesSubstance Use DisorderSuicideTechnologyTelephoneTimeTreatment outcomeUnderserved PopulationVisitVulnerable PopulationsWomanaddictionalcohol abuse therapyalcohol misusealcohol use disordercare providersclinical careclinical practicecomorbiditydigitaldigital tooldigital treatmentdisabilitydisparity reductiondrinkingethnic minorityexperiencehealth care disparityimprovedinsurance claimsmachine learning methodmenmortalityoutpatient programspandemic diseaseprogramsracial minorityrural arearural residenceruralityservice utilizationsextelehealthtooltraiturban areaurban disparityurban residence
项目摘要
PROJECT SUMMARY
While alcohol use disorder (AUD) is a leading cause of morbidity and mortality, and efficacious medication and
behavioral treatments exist, only a small minority with AUD in the US receive any AUD treatment.
Additionally, there are substantial disparities in receiving AUD care across several groups (e.g., racial/ethnic
minorities, women, those who live in rural locations). The COVID-19 pandemic has led to a worsening of the
situation with both increases in unhealthy alcohol use and disruptions in care. However, one potentially
positive change is the dramatic rise in use of telehealth. Telehealth for treatment of AUD could increase access
to care and thereby improve treatment outcomes, but much remains unknown about how telehealth is being
incorporated into AUD care, characteristics of the patients who are receiving different patterns of AUD care
and their AUD providers, and the subsequent outcomes. It is also unclear whether telehealth in AUD care is
reducing or widening disparities in utilization.
To address this knowledge gap we will use a mixed methods study that combines analysis of Medicare,
Medicaid, and commercial insurance claims from 2016-2024, with qualitative interviews, to achieve the
following study aims: 1) identify initial longitudinal patterns of telehealth versus in-person AUD care and
assess patient, provider, and community characteristics associated with different patterns; 2) characterize the
longer-term quality outcomes associated with these initial tele-AUD patterns; 3) assess disparities in AUD
utilization over time and the association between tele-AUD use and these disparities; and, 4) explore the
perspective of providers and individuals with problematic drinking on the quality of different care patterns that
incorporate telehealth and other digital tools.
This study will provide important new information that can inform clinical practice regarding the role of
telehealth in AUD care going forward. It can help answer questions about how best to use tele-AUD to improve
access to and quality of AUD care, reduce disparities, and support recovery. The results will also inform the
ongoing debates on telehealth regulation and reimbursement policy in Congress, state legislatures, Medicaid
programs, and private insurers.
项目摘要
虽然酒精使用障碍(AUD)是发病率和死亡率的主要原因,但有效的药物和
尽管存在行为治疗,但在美国只有少数AUD患者接受任何AUD治疗。
此外,在接受AUD护理方面,几个群体之间存在很大差异(例如,种族/族裔
少数民族、妇女、农村居民)。2019冠状病毒病大流行导致了
这种情况既增加了不健康的酒精使用,也破坏了护理。然而,一个潜在的
积极的变化是远程保健的使用急剧增加。治疗AUD的远程医疗可以增加获得
护理,从而改善治疗结果,但仍有很多关于远程医疗是如何被未知
纳入AUD护理,接受不同AUD护理模式的患者的特征
和他们的澳元供应商,以及随后的结果。目前还不清楚远程医疗在AUD护理中是否
减少或扩大利用率的差距。
为了解决这一知识差距,我们将使用混合方法研究,结合医疗保险的分析,
医疗补助,商业保险索赔从2016年至2024年,与定性访谈,以实现
以下研究目的:1)确定远程医疗与面对面AUD护理的初始纵向模式,
评估与不同模式相关的患者、提供者和社区特征; 2)表征
与这些初始远程澳元模式相关的长期质量结果; 3)评估澳元差异
随着时间的推移使用和远程AUD使用之间的关联和这些差异;以及,4)探索
提供者和有饮酒问题的个人对不同护理模式质量的看法,
包括远程保健和其他数字化工具。
这项研究将提供重要的新信息,可以告知临床实践的作用,
远程医疗在AUD护理中的应用。它可以帮助回答有关如何最好地使用tele-AUD来提高
获得AUD护理的机会和质量,减少差距,支持康复。结果也将告知
在国会、州立法机构、医疗补助计划中正在进行的关于远程医疗监管和报销政策的辩论
计划和私人保险公司。
项目成果
期刊论文数量(0)
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