Mental Health Care Dominates Telehealth Visits, Study Finds

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In an analysis published in the Annals of Internal Medicine, investigators from the Agency for Healthcare Research and Quality (AHRQ) have revealed trends in telehealth usage, particularly in the realm of mental health care. The study, drawing on data from the 2021 Medical Expenditure Panel Survey (MEPS), highlighted that a significant portion of telehealth visits were for mental health services despite the overall telehealth utilization being relatively low.¹

The analysis encompassed 232,024 health care visits, with the aim to evaluate telehealth utilization patterns within the civilian noninstitutionalized population. The data revealed that only 9.6% of health care visits occurred via telehealth. However, a substantial 43.2% of these telehealth visits were consultations with psychiatrists, investigators noted. When considering different types of mental health clinicians, this figure ranged from 43.2% to 54.1%, underscoring the heavy reliance on telehealth for mental health services.

In the mental health care domain specifically, telemedicine has shown to be a great asset in improving equity and access for patients.

“There definitely are certain patients and certain types of illnesses that I do believe may really benefit from in-person, in-office visits. And some examples of that would be many individuals who struggle with addiction, with substance use disorders, whether it's alcoholism, benzodiazepine use, or opioid use, some individuals who may have a history of psychosis—or you're worried about them developing schizophrenia, or having schizophrenia, for example,” Chris Pagnani, MD, medical director and founder of Rittenhouse Psychiatric Associates, said in an interview with AJMC.² “And then individuals who are in crisis, or you're concerned about safety.”

In stark contrast, telehealth visits constituted just 6.1% of primary care consultations and 7.8% of visits to specialty physicians.¹ These figures highlight a significant disparity in telehealth adoption across different medical disciplines.

The study also tracked changes in telehealth usage following the peak of the public health emergency. It found that the percentage of telehealth visits for non–mental health services experienced a significant decline, dropping by 44% to 49%. In comparison, the reduction in telehealth visits for mental health services was less pronounced, decreasing by 18% to 19%.

These trends suggest that although telehealth usage surged during the height of the public health emergency, its adoption has receded toward preemergency levels for most non–mental health services. Conversely, mental health care via telehealth has maintained a more substantial portion of its increased usage.

The findings from this study underscore the critical role telehealth has played, and continues to play, in the delivery of mental health services. The sustained higher levels of telehealth usage for mental health care indicate its potential as a valuable tool for addressing mental health needs, particularly in a landscape where access to in-person psychiatric services may be limited.

Furthermore, the relatively lower adoption rates of telehealth for primary and specialty care suggest potential areas for growth and improvement. As health care systems continue to adapt post emergency, understanding and addressing the barriers to telehealth adoption in these fields could enhance overall health care delivery and accessibility.

The AHRQ's analysis of the 2021 MEPS data provides crucial insights into the patterns of telehealth usage, highlighting a predominant reliance on telehealth for mental health services. As the health care industry evolves, these findings emphasize the importance of integrating telehealth into mental health care strategies and exploring its broader applications across various medical disciplines.

References

1. Decker SL, Encinosa WE, Zuvekas SH. Use of telehealth among medical visits in the United States: results from the 2021 medical expenditure panel survey. Ann Intern Med. Published online June 4, 2024. doi:10.7326/M24-0137

2. Grossi G. Dr Chris Pagnani: Telemedicine as a tool for better mental health care access. AJMC®. May 8, 2024. Accessed June 3, 2024. https://www.ajmc.com/view/dr-chris-pagnani-telemedicine-as-a-tool-for-better-mental-health-care-access