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，酒精和物质使用障碍（AUD 和 SUD）非常普遍，并且 死亡、发病、个人和社会成本的既定原因。存在大量未满足的需求 可用的 AUD 和 SUD 治疗方案，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，特别是对于服务不足的人群。 COVID-19 大流行需要 通过采用现有技术并放松对远程医疗使用的管制作为替代，快速转向远程医疗 到现场服务。采用远程医疗进行 AUD 和 SUD 治疗可能特别有利于 解决医疗服务不足的人群（例如由联邦合格医疗机构提供服务的人群）的获取问题 健康中心 (FQHC)。结果将确定远程医疗政策（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，可以告知健康的持久变化 改善 AUD 和 SUD 服务获取的系统。核心假设是政策支持 COVID-19 期间的远程医疗将与 AUD 和 SUD 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-19 进行法律分析 19 项远程医疗政策； 2. 评估关于 AUD 和 SUD 服务利用率的州医疗补助远程医疗政策 FQHC，以及 3. 分析州医疗补助 COVID-19 远程医疗政策对 FQHC 特殊人群的影响。 该研究将利用互联健康政策中心的政策查找器资源来进行 COVID-19 远程医疗 患者特征结果数据的政策数据和 FQHC 计划数据（例如人口统计信息） 以及提供的服务（例如 AUD 和 SUD 服务的就诊次数和患者人数）。我们将进行 一系列双重差异模型并使用其他利用纵向数据的分析方法进行比较 通过对州医疗补助远程医疗政策的法律研究制定的分类远程医疗政策。目标 由于 COVID-19 导致远程医疗政策发生变化，拟议研究的内容本质上是创新的 大流行是新颖的，为评估远程医疗对 AUD 和 SUD 的影响提供了独特的机会 获取和利用，特别是对于服务不足的人群。确定改善澳元获取的政策 SUD 护理和治疗将对大流行后的卫生服务产生持久且重大的影响， 例如永久政策的采用或适用于不同的付款人、环境和人群。