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.

抽象的 在美国，酒精和药物使用障碍（AUD和SUD）非常普遍，并且是 已建立的死亡率，发病率，个人和社会成本的原因。有很大的未满足需求 可访问的AUD和SUD治疗选项，但是远程医疗是有效的解决方案 解决治疗的障碍，特别是服务不足的人群。互联-19大流行需要 通过调整可用技术并放弃远程医疗作为替代品来快速对远程医疗的枢纽 进行面对面的服务。采用远程医疗对AUD和SUD治疗可能特别有利 解决医疗服务不足的人群的访问问题，例如联邦资格服务的问题 卫生中心（FQHC）。结果将确定远程医疗策略（即仅视听远程医疗，提供商类型 扩展，服务类型的扩展）在大流行期间有效，以告知持久的健康变化 系统改善了对AUD和SUD服务的访问。中心假设是支持政策 Covid-19期间的远程医疗将与增加的AUD和SUD服务利用率呈正相关 服务不足的人群。我们的具体目的如下：1。对州医疗补助的法律分析 - 19远程医疗政策； 2。在AUD和SUD服务利用率上评估州医疗补助远程医疗保健政策 FQHC和3。分析国家医疗补助协会-19远程医疗政策对FQHC特殊人群的影响。 该研究将雇用连接卫生政策的中心为COVID-19远程医疗 策略数据和FQHC程序数据有关患者特征的结果数据（例如，人口统计信息） 提供的服务（例如，访问次数和AUD和SUD服务的患者数量）。我们将进行 一系列差异差异模型，并使用纵向数据使用其他分析方法来比较 通过有关州医疗补助远程医疗政策的法律研究制定的分类远程医疗政策。目的 拟议的研究本质上是创新的，因为Covid-19产生的远程医疗政策变化 大流行是新颖的，并提供了评估远程医疗对AUD和SUD的影响的独特机会 访问和利用，特别是服务不足的人群。确定改善访问AUD的政策 大流行后，肥皂水护理和治疗将对卫生服务产生持久的影响， 例如永久采用政策或向不同的付款人，设置和人口申请。