Table 1. Mental Health Specialty Practice and Patient Characteristics in the Pandemic Cohort After Matching.
| Characteristic | No. (%) | Absolute SMD by level of telemedicine useb | ||||
|---|---|---|---|---|---|---|
| Matched sample overall | Lowest telemedicine usea | Middle telemedicine usea | Highest telemedicine usea | Lowest vs middle | Lowest vs highest | |
| 2019 Practices | ||||||
| Total practices | 11 170 (100) | 3180 (28.5) | 3793 (33.9) | 4197 (37.6) | NA | NA |
| Mental health visits per practice, mean (SD) | 520 (994) | 475 (867) | 553 (1075) | 523 (1007) | 0.080 | 0.052 |
| Telemedicine share in year 1 of pandemic, mean % (SD) | 64.8 (34.8) | 14.6 (16.7) | 74.0 (11.8) | 94.6 (2.3) | NA | NA |
| Practice location | ||||||
| Northeast | 3586 (32.1) | 962 (30.3) | 1161 (30.6) | 1460 (34.8) | 0.008 | 0.097 |
| Midwest | 2189 (19.6) | 639 (20.1) | 792 (20.9) | 763 (18.2) | 0.019 | 0.049 |
| South | 3329 (29.8) | 1013 (31.9) | 1168 (30.8) | 1149 (27.4) | 0.023 | 0.098 |
| West | 2066 (18.5) | 566 (17.8) | 672 (17.7) | 825 (19.7) | 0.002 | 0.048 |
| No. of clinicians in the practice | ||||||
| 1 | 8439 (75.6) | 2449 (77.0) | 2760 (72.8) | 3230 (77.0) | 0.098 | 0.001 |
| 2-9 | 2138 (19.1) | 598 (18.8) | 789 (20.8) | 751 (17.9) | 0.050 | 0.024 |
| ≥10 | 593 (5.3) | 133 (4.2) | 244 (6.4) | 216 (5.1) | 0.100 | 0.046 |
| Share of visits with a mental health focus, mean % (SD) | 95.9 (12.1) | 95.4 (14.1) | 95.7 (12.3) | 96.6 (10.1) | 0.017 | 0.061 |
| Share of visits delivered from urban location, mean % (SD) | 88.5 (31.8) | 87.0 (33.6) | 87.9 (32.4) | 90.2 (29.6) | 0.028 | 0.100 |
| Share of visits delivered to patients with Medicaid, mean % (SD) | 30.2 (27.5) | 31.3 (28.6) | 30.9 (27.1) | 28.6 (26.9) | 0.013 | 0.098 |
| 2019 Patient characteristics | ||||||
| Patients with SMI | 120 050 (100) | 30 025 (25.0) | 48 126 (40.1) | 41 899 (34.9) | NA | NA |
| With schizophrenia | 59 785 (49.8) | 15 211 (50.7) | 24 270 (50.4) | 20 354 (48.6) | 0.005 | 0.042 |
| With bipolar I disorder | 60 265 (50.2) | 14 814 (49.3) | 23 856 (49.6) | 21 545 (51.4) | 0.005 | 0.042 |
| Age, mean (SD), y | 56.5 (14.5) | 57.2 (14.6) | 55.7 (14.4) | 56.8 (14.5) | 0.096 | 0.022 |
| Age group, y | ||||||
| <40 | 18 873 (15.7) | 4446 (14.8) | 8011 (16.6) | 6416 (15.3) | 0.051 | 0.014 |
| 40-54 | 33 008(27.5) | 7997 (26.6) | 13 842 (28.8) | 11 169 (26.7) | 0.048 | 0.001 |
| 55-64 | 29 726 (24.8) | 7375 (24.6) | 11 988 (24.9) | 10 363 (24.7) | 0.008 | 0.004 |
| 65-74 | 27 924 (23.3) | 7275 (24.2) | 10 426 (21.7) | 10 223 (24.4) | 0.061 | 0.004 |
| ≥75 | 10 519 (8.8) | 2932 (9.8) | 3859 (8.0) | 3728 (8.9) | 0.061 | 0.030 |
| Race and ethnicity | ||||||
| Asian or Pacific Islander | 1848 (1.5) | 535 (1.8) | 688 (1.4) | 625 (1.5) | 0.028 | 0.023 |
| Black | 16 284 (13.6) | 4197 (14.0) | 6852 (14.2) | 5235 (12.5) | 0.007 | 0.044 |
| Hispanic | 3633 (3.0) | 874 (2.9) | 1278 (2.7) | 1481 (3.5) | 0.016 | 0.035 |
| White | 93 938 (78.2) | 23 411(78.0) | 37 514 (77.9) | 33 013 (78.8) | 0.001 | 0.020 |
| Otherc | 4347 (3.6) | 1008 (3.4) | 1794 (3.7) | 1545 (3.7) | 0.020 | 0.018 |
| Sex | ||||||
| Male | 53 412 (44.5) | 13 543 (45.1) | 21 550 (44.8) | 18 319 (43.7) | 0.007 | 0.028 |
| Female | 66 638 (55.5) | 16 482 (54.9) | 26 576 (55.2) | 23 580 (56.3) | 0.007 | 0.028 |
| Rural residence | 22 706 (18.9) | 5450 (18.2) | 10 336 (21.5) | 6920 (16.5) | 0.084 | 0.043 |
| Dually enrolled in Medicaid | 75 794 (63.1) | 18 969 (63.2) | 31 120 (64.7) | 25 705 (61.3) | 0.031 | 0.038 |
| Original Medicare eligibility based on disability | 99 072 (82.5) | 24 495 (81.6) | 40 449 (84.0) | 34 128 (81.5) | 0.065 | 0.003 |
| Enrolled in Medicare Part D | 99 459 (82.8) | 24 718 (82.3) | 39 975 (83.1) | 34 766 (83.0) | 0.020 | 0.017 |
| Chronic conditions | ||||||
| 0-1 | 14 290 (11.9) | 3274 (10.9) | 6067 (12.6) | 4949 (11.8) | 0.053 | 0.029 |
| 2-6 | 52 475 (43.7) | 12 684 (42.2) | 21 510 (44.7) | 18 281 (43.6) | 0.049 | 0.028 |
| 7-9 | 27 401 (22.8) | 6927 (23.1) | 10 724 (22.3) | 9750 (23.3) | 0.019 | 0.005 |
| ≥10 | 25 884 (21.6) | 7140 (23.8) | 9825 (20.4) | 8919 (21.3) | 0.081 | 0.060 |
Abbreviations: NA, not applicable; SMD, standardized mean difference; SMI, serious mental illness.
a
Practices were categorized based on the proportion of telemental health visits relative to all mental health visits (telemedicine and in-person visits) provided during the first year of the pandemic (March 2020-February 2021) into 3 groups: lowest telemedicine use (0%-49% TMH visits), middle telemedicine use (50%-89% TMH visits), or highest telemedicine use (90%-100% TMH visits).
b
SMDs greater than 0.1 indicate a sizeable difference.
c
Other race includes American Indian, Alaska Native, and unknown.