Health-care–Related Practices in Virtual Behavioral Health Treatment for Major Depression Before and During the COVID-19 Pandemic. Issue 4 (9th April 2023)

• Record Type: Journal Article
• Authors: Weinfield, Nancy S.; Tavel, Heather M.; Goodrich, Glenn; McCracken, Courtney E.; Basra, Sundeep; Gander, Jennifer C.; Davis, Teaniese L.; Ritzwoller, Debra P.; Roblin, Douglas W.
• Is Part Of: Medical care. Volume 61:Issue 4(2023)supplement 1
• Page Start: S47
• Page End: S53
• Publication Date: 2023-04-09
• Subjects: depression -- behavioral health -- telehealth -- virtual care -- measurement-based care; Economics, Medical -- Periodicals; Insurance, Health -- Periodicals; Santé, Services de -- Administration -- Périodiques; Soins médicaux -- Périodiques; Medical economics -- Periodicals; Health insurance -- Periodicals; Medical economics -- United States -- Periodicals; Health insurance -- United States -- Periodicals; Comprehensive Health Care -- Periodicals; Personal Health Services -- Periodicals; Gezondheidszorg; Économie de la santé -- Périodiques; Santé, Services de -- Périodiques; Health insurance; Medical economics; United States; Periodicals; 362.10973
• DOI: 10.1097/MLR.0000000000001815
• Languages: English
• ISSNs: 0025-7079

Abstract

Abstract : Background: The abrupt shift to virtual care at the onset of the COVID-19 pandemic had the potential to disrupt care practices in virtual behavioral health encounters. We examined changes over time in virtual behavioral health-care-related practices for patient encounters with diagnoses of major depression. Methods: This retrospective cohort study utilized electronic health record data from 3 integrated health care systems. Inverse probability of treatment weighting was used to adjust for covariates across 3 time periods, prepandemic (January 2019–March 2020), peak-pandemic shift to virtual care (April 2020–June 2020), and recovery of health care operations (July 2020–June 2021). First virtual follow-up behavioral health department encounters after an incident diagnostic encounter were examined for differences across the time periods in rates of antidepressant medication orders and fulfillments, and completion of patient-reported symptoms screeners in service of measurement-based care. Results: Antidepressant medication orders declined modestly but significantly in 2 of the 3 systems during the peak-pandemic period but rebounded during the recovery period. There were no significant changes in patient fulfillment of ordered antidepressant medications. Completion of symptom screeners increased significantly in all 3 systems during the peak-pandemic period and continued to increase significantly in the subsequent period. Conclusions: A rapid shift to virtual behavioral health care was possible without compromising health-care-related practices. The transition and subsequent adjustment period have instead been marked by improved adherence to measurement-based care practices in virtual visits, signaling a potential new capacity for virtual health care delivery.