A comparison of patient‐reported mental health outcomes for the Department of Veterans Affairs' regional telehealth and Community Care Programs

• Published in: Health services research 2022-08, Vol.57 (4), p.755-763
• Main Authors: Fortney, John C., Carey, Evan P., Rajan, Suparna, Rise, Peter J., Gunzburger, Elise C., Felker, Bradford L.
• Format: Article
• Language: English
• Subjects: Access; access to care; Care and treatment; Chart reviews; Clinical outcomes; Community health care; Data collection; Data warehouses; Depression (Mood disorder); Depression, Mental; Health services; Health status; Medical diagnosis; Mental depression; Mental disorders; Mental health; Mental health services; Patient satisfaction; Patient-centered care; Patients; Polls & surveys; Post traumatic stress disorder; Psychiatric services; Psychological stress; Quasi-experimental methods; Regions; Satisfaction; Severity; Surveys; Symptoms; telehealth; Telemedicine; Veteran and Military Care; Veterans
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.13993

Objectives To compare patient‐reported outcomes for veterans with limited access to Department of Veterans Affairs (VA) mental health services referred to the Veterans Community Care Program (VCCP) or regional telehealth Clinical Resource Hubs‐Mental Health (CRH‐MH). Data Sources This national evaluation used secondary data from the VA Corporate Data Warehouse, chart review, and primary data collected by baseline survey between October 8, 2019 and May 27, 2020 and a 4‐month follow‐up survey. Study Design A quasi‐experimental longitudinal study design was used to sample 545 veterans with VCCP or CRH‐MH referrals for new treatment episodes. Patient‐reported outcomes included symptom severity, perceived access, utilization, and patient‐centeredness. Data Collection During the baseline and follow‐up surveys, all veterans were administered the Patient Health Questionnaire‐8 (PHQ‐8) to assess depression severity, and veterans with a provisional diagnosis of posttraumatic stress disorder (PTSD) were also administered the PTSD Checklist for DSM‐5 (PCL‐5) to assess PTSD symptom severity. The 4‐month follow‐up survey also asked about perceived access using the Perceived Access Inventory, the number of encounters, and patient‐centeredness of care using the Patient‐Centered Care portion of the Veterans Satisfaction Survey. Principal Findings Results indicated that compared to VCCP consults, veterans with CRH‐MH consults reported 0.65 (CI95 = 0.51–0.83, p