Long-Stay Nursing Home Residents with Dementia: Telemedicine Mental Health Use during the COVID-19 Pandemic.

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY Journal of the American Medical Directors Association Pub Date : 2025-01-16 DOI:10.1016/j.jamda.2024.105438
Qiuyuan Qin, Helena Temkin-Greener, Adam Simning, Reza Yousefi-Nooraie, Shubing Cai
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Abstract

Objective: To examine racial and ethnic differences in telemedicine mental health (tele-MH) use among nursing home (NH) long-stay residents with Alzheimer's disease and related dementias (ADRD) during the pandemic.

Design: Observational study.

Setting and participants: The 2020-2021 Minimum Data Set 3.0, Medicare datasets, and Nursing Home Compare data were linked. A total of 259,467 NH long-stay residents with ADRD and 14,159 NHs were included.

Methods: The outcome variable was the percentage of NH ADRD long-stayers who used tele-MH in 2021. The main independent variables were NH racial and ethnic compositions (ie, percentages of Black and Hispanic residents) and individual race and ethnicity. We conducted a set of logistic regression models with NH random effect. We first included only individual characteristics and then added NH characteristics.

Results: Approximately 7% and 35% of the study cohort had tele-MH use and MH use in 2021, respectively. In our study cohort, 13.7% were Black, 6.6% were Hispanic, and 79.7% were white residents. The mean age was 83.4. After adjusting for NH characteristics, we found residents in NHs with a high proportion of Hispanic residents were more likely to use tele-MH both compared with those in NHs with a low proportion [odds ratio (OR), 1.867; 95% CI, 1.566-2.226], whereas residents in NHs with a high proportion of Black residents were less likely to use tele-MH both compared with those in NHs with a low proportion (OR, 0.843; 95% CI, 0.928-0.997).

Conclusions and implications: Telemedicine may offer an opportunity for NHs with a higher proportion of Hispanic residents to better address their needs for MH services. However, NHs with a higher proportion of Black residents may face challenges in telemedicine adoption. Future studies are needed to better understand factors that could impact tele-MH use in NHs and reasons that lead to racial and ethnic differences.

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患有痴呆症的长期护理之家居民:COVID-19大流行期间远程医疗心理健康的使用
目的:探讨大流行期间阿尔茨海默病及相关痴呆(ADRD)长期居住在养老院(NH)的居民远程医疗心理健康(tele-MH)使用的种族差异。设计:观察性研究。环境和参与者:2020-2021年最低数据集3.0、医疗保险数据集和养老院比较数据被链接。共包括259,467名患有ADRD的NH长期居民和14,159名NHs居民。方法:结局变量为2021年使用远程mh的NH ADRD长期住院患者的百分比。主要的自变量是NH种族和民族构成(即黑人和西班牙裔居民的百分比)和个人种族和民族。我们建立了一套具有NH随机效应的logistic回归模型。我们首先只考虑了个体特征,然后加入了NH特征。结果:大约7%和35%的研究队列在2021年分别使用远程MH和MH。在我们的研究队列中,13.7%为黑人,6.6%为西班牙裔,79.7%为白人。平均年龄为83.4岁。在调整了NH特征后,我们发现西班牙裔居民比例高的NHs居民比西班牙裔居民比例低的NHs居民更有可能使用远程mh(优势比[OR], 1.867;95% CI, 1.566-2.226),而黑人居民比例高的NHs居民与黑人居民比例低的NHs居民相比,使用远程mh的可能性更小(OR, 0.843;95% ci, 0.928-0.997)。结论和意义:远程医疗可能为西班牙裔居民比例较高的NHs提供机会,以更好地解决他们对MH服务的需求。然而,黑人居民比例较高的NHs在采用远程医疗方面可能面临挑战。未来的研究需要更好地了解可能影响NHs远程mh使用的因素以及导致种族和民族差异的原因。
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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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