Wednesday, August 9, 2023

Patients Found Less Likely to Cancel Telepsychiatry Visits, Study Shows

Patients with depression who scheduled an appointment to see a psychiatrist between July 2020 and October 2022 were less likely to miss or cancel the appointment if it was virtual compared with in person, according to a report published today in Psychiatric Services.

“Appointment completion was higher for telepsychiatry than for in-person care among all patient characteristics studied,” wrote Catherine K. Ettman, Ph.D., of Johns Hopkins Bloomberg School of Public Health and colleagues. The findings “suggest that telepsychiatry is associated with improved efficiency and continuity of care.”

The researchers examined electronic health records for 12,894 patients aged 10 or older with a diagnosis of depression who scheduled 586,266 psychiatric outpatient appointments at Johns Hopkins Medicine between November 2017 and October 2022. They compared the number of in-person and telepsychiatry appointments that patients completed, cancelled, or failed to show up to before the pandemic with these outcomes of in-person and telepsychiatry appointments scheduled from July 2020 to October 2022. (The researchers did not analyze the appointment trends between March 2020 and June 2020 due to the fall in overall appointment completion rates caused by the pandemic.)

Prior to the pandemic, the number of patients who scheduled and completed in-person appointments vastly outnumbered those who scheduled and completed telepsychiatry appointments. Between July 2020 and October 2022, however, telehealth appointments outnumbered the in-person appointments. During this period, 13.3% of telepsychiatry appointments were canceled compared with 18% of in-person appointments.

Overall, telepsychiatry appointments were 1.30 times more likely to be completed than in-person appointments. Moreover, the likelihood that a telepsychiatry appointment would be completed relative to an in-person appointment increased steadily between July 2020 and October 2022. Ettman and colleagues noted that the increased likelihood of completion of telepsychiatry appointments remained regardless of the patient’s age, gender, race, insurance, or employment status.

“[H]ealth systems may wish to maintain telepsychiatry to optimize delivery of care and to improve patient outcomes,” Ettman and colleagues wrote.

However, they noted that telehealth may not be accessible to all patients and may exacerbate existing disparities. For instance, they found that patients who were younger, female, White, employed, or had higher socioeconomic status or private insurance were significantly more likely to schedule telepsychiatry appointments compared with in-person appointments after the pandemic’s onset.

“These findings merit future study,” they wrote. “Additional research on patient preferences, potential disparities in access to care, and efforts to reduce barriers to telehealth is warranted.”

For related information, see the Psychiatric News article “After the Pandemic: What Will the ‘New Normal’ Be in Psychiatry?

(Image: iStock/PeopleImages)

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