Primary Submission Category: Health care/services
Trends in telehealth and in-person psychiatric care from 2017-2022 among patients with depression in a large US academic medical system
Authors: Catherine Ettman Carly Lupton Brantner Michael Albert Fernando Goes Ramin Mojtabai Stanislav Spivak Elizabeth Stuart Peter Zandi
Presenting Author: Catherine Ettman*
Telehealth, which increased rapidly after the start of the COVID-19 pandemic, may improve access to care and reduce barriers to appointment completion. We aimed to assess the differences in completion rates between telehealth and in-person outpatient appointments in a large, urban Department of Psychiatry among patients with depression. We conducted a longitudinal cohort study of patients with depression using electronic health records (EHR) from Johns Hopkins Medicine from November 2017 through October 2022. Participants were patients ≥10 years old with a depression diagnosis who had at least one scheduled outpatient appointment in the Department of Psychiatry between November 2017 – October 2022. With almost no telehealth appointments conducted before the COVID-19 pandemic, telehealth was then the modal form of care in the Department of Psychiatry from April 2020 through October 2022, with the total number of telehealth and in-person appointments nearly converging by October 2022. In analyses using logistic regression models with random effects for patient IDs, appointments had 1.30 (95%CI: 1.27, 1.34) times the odds of being completed if conducted over telehealth relative to in-person from July 2020 through October 2022. The association remained significant after adjusting for patient characteristics. Telehealth completion rates were higher than in-person completion rates across all patient groups. Telehealth appointments were completed at a higher rate than in-person appointments in a large, urban Department of Psychiatry, suggesting improved efficiency and continuity of care. As in-person operations resume following the COVID-19 pandemic, it may be beneficial to maintain options for care via telehealth to optimize delivery of care and patient outcomes.