RT Journal Article
SR Electronic
T1 Follow-Up Care of Patients with Newly Diagnosed Depression After Widespread Implementation of Telemedicine
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 3471
DO 10.1370/afm.21.s1.3471
VO 21
IS Supplement 1
A1 Athyal, Vidush
A1 Stinis, Sharon
YR 2023
UL http://www.annfammed.org/content/21/Supplement_1/3471.abstract
AB Context: Patients who are diagnosed with depression often do not get any follow-up care. This deficiency led to a national HEDIS measure that calls for patients to get follow-up care within the first 30 days of being screened positive for depression. Studies have shown that depression outcomes improve with closer follow-up care.Objective: To compare the change in percentage of follow-up care in newly diagnosed depression over a two-year period, specifically examining the pre-pandemic and pandemic eras. To determine if the increased usage of telemedicine in the pandemic era led to an increase in HEDIS-defined follow-up care for newly diagnosed patients with depression.Study Design and Analysis: Prospective observational design. Chi-square and T-tests were used to determine statistical significance at p-value<=0.05.Setting or Dataset: All patient encounters between February 1, 2019-January 31, 2020 (pre-pandemic) and February 1, 2020-January 31, 2021 (pandemic) in the Kaiser Permanente Southern California (KPSC) database were evaluated for new diagnosis of depression and 30 day follow-up for the depression.Population Studied: Patients within the KPSC medical system with a new diagnosis of depression based on ICD-10 codes within the last 365 days. Patients were excluded if they had a diagnosis of depression or bipolar disorder or had received psychotherapy, antidepressant medicine or hospice care within the previous year.Characteristics of patients studied included: age, gender, ethnicity, education level, income, and the Elixhauser Comorbidity Index.Intervention/Instrument: N/AOutcome Measures: Primary endpoint evaluated was patients who have received follow-up for their new diagnosis of depression within 30 days, as well as type of follow-up (telephone visit, video visit, office visit or home visit).Results: The absolute number of new diagnoses of depression remained constant during the year preceding the Covid pandemic and the first year of the pandemic (349K vs 359K). Overall, 30-day follow-up of depression fell from 20.5% pre-pandemic to 12.5% during the first year of the pandemic. Despite this decrease telephone visits were used by 10% of patients pre-pandemic but increased to 44% in 2020. Similarly, the proportion of video visit follow-ups increased by 17%.Conclusions: During the first year of the Covid pandemic, there was a significant decrease in 30 day follow-up of depression. However, there was an increase in use of phone and video consultation.