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Impact of Telemedicine on Utilization of Psychiatric Resources in New York City during the COVID-19 Pandemic

Ricklan, Sarah J; Sohler, Nancy; Ezie, C E Chiemeka; Avalone, Lynsey; Dinsell, Victoria; Lewis, Crystal; Fattal, Omar; Balan, Sabish; McQuistion, Hunter; Pastore, Frank; Sarcevic, Nermica; Swift, Ronnie; Espejo, Gemma; Lorenz, Carina
This study sought to evaluate the impact of telepsychiatry during the COVID-19 pandemic among patients discharged from psychiatric inpatient units in the New York City Health and Hospitals Corporation system. We compared patients discharged to telepsychiatry (April 2020, n = 739) and in-person follow-up (May 2019, n = 527); we collected number, timing and attendance for follow-up appointments and number and timing of emergency room (ER) visits and readmissions. We used logistic regression to evaluate the odds of having these encounters and Kaplan-Meier analyses to compare time to these encounters. Patients discharged in 2020 were more likely to have a follow-up (29.4 vs. 19.9%, p < 0.001) and an ER visit or readmission (40.5 vs. 28.7%, p < 0.001). Kaplan-Meier analyses showed shorter time to first follow-up (chi-square = 14.69, d.f.=1, p < 0.0001, follow-ups = 322) and ER visit or readmission (chi-square = 19.57, d.f.=1, p < 0.0001, ER visits or admissions = 450) in the 2020 cohort. In multivariable analyses, patients discharged in 2020 were more likely to have a follow-up visit (adjusted OR 1.85, 95% confidence interval 1.40, 2.45, p < 0.0001). We found an increase in psychiatric service utilization during the pandemic, with an increase in and shorter time until outpatient visits and ER visits or readmissions. Although increased use of psychiatric services during the height of the COVID-19 pandemic is encouraging, it also points to the depth of the crisis among vulnerable populations; this pattern warrants further exploration and intervention.
PMID: 38105337
ISSN: 1573-2789
CID: 5612592

Seeking Value: Balancing Cost and Quality in Psychiatric Care

McQuistion, Hunter L
PMID: 36355594
ISSN: 1538-1145
CID: 5357452

Textbook of Community Psychiatry

Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S
[S.l.] : Springer, 2022
Extent: 1 v.
ISBN: 978-3-031-10239-4
CID: 5368662

Introduction: Community Psychiatry on the Move

Chapter by: McQuistion, Hunter L; Sowers, Wesley E; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 3-7
ISBN: 978-3-031-10239-4
CID: 5368672

Exercising Effective Leadership

Chapter by: Runnels, Patrick S; Feldman, Jacqueline Maus; McQuistion, Hunter L
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 43-50
ISBN: 978-3-031-10239-4
CID: 5368682

Psychiatric Care for People Experiencing Homelessness

Chapter by: Carino, Tony; McQuistion, Hunter L
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 577-591
ISBN: 978-3-031-10239-4
CID: 5368722

Financing of Community Behavioral Health Services

Chapter by: Shoyinka, Sosunmolu; Sowers, Wesley E; McQuistion, Hunter L
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 775-787
ISBN: 978-3-031-10239-4
CID: 5368752

Mentoring and Supervision in Community Psychiatry

Chapter by: McQuistion, Hunter L; Rosenfield, Paul; Runnels, Patrick S
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 849-862
ISBN: 978-3-031-10239-4
CID: 5368762

Community Psychiatry: Past, Present, and Future

Chapter by: Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S
in: Textbook of Community Psychiatry by Sowers, Wesley E; McQuistion, Hunter L; Ranz, Jules M; Feldman, Jacqueline Maus; Runnels, Patrick S [Eds]
[S.l.] : Springer, 2022
pp. 891-905
ISBN: 978-3-031-10239-4
CID: 5368772

Rapid Telepsychiatry Implementation During COVID-19: Increased Attendance at the Largest Health System in the United States

Avalone, Lynsey; Barron, Charles; King, Carla; Linn-Walton, Rebecca; Lau, Jen; McQuistion, Hunter L; Popiel, Maryann; Balasubramaniam, Meera; Freeman, Richard; Fattal, Omar
OBJECTIVE/UNASSIGNED:This study aimed to examine differences in completion rates between telepsychiatry and in-person visits during the COVID-19 pandemic and a prior reference period. METHODS/UNASSIGNED:The authors used electronic medical record data along with chi-squared or t tests to compare patients' demographic characteristics. Generalized estimating equations for estimating the odds of primary and secondary outcomes were used, controlling for demographic characteristics. RESULTS/UNASSIGNED:During COVID-19, the odds of completing a telepsychiatry visit (N=26,715) were 6.68 times the odds of completing an in-person visit (N=11,094). The odds of completing a telepsychiatry visit during COVID-19 were 3.00 times the odds of completing an in-person visit during the pre-COVID-19 reference period (N=40,318). CONCLUSIONS/UNASSIGNED:In this cross-sectional study, outpatient adult mental health clinic telepsychiatry appointments, largely by telephone, were strongly associated with a higher rate of visit completion compared with in-person visits during and prior to the COVID-19 pandemic. Regulators should consider permanently enabling reimbursement for telephone-only telepsychiatry visits.
PMID: 33730881
ISSN: 1557-9700
CID: 4817872