Implications of broadband internet access for telehealth provision at outpatient mental health facilities Open Access

Abstract

Background: Telehealth increases access to mental health services, particularly for rural populations. Poor internet access is common in rural areas and can be a barrier to telehealth services, such as videoconferencing. Currently, little is known about how internet access impacts the provision of telehealth services at mental health facilities.

Objective: Measure the association between county-level broadband access and telehealth provision at mental health facilities and determine if this association changes based on rurality. 

Methods: Outpatient mental health facility data were merged with broadband access data, along with area and facility-level confounders. Rurality and internet access were interacted in an adjusted multivariate logistic regression model to predict the probability of telehealth.

Results: The study included 8,845 U.S. outpatient mental health facilities, about two thirds of which (68.8%) offered telehealth. Among facilities in non-urban counties, better internet access was associated with a 1.61 percentage point increase in the likelihood of telehealth provision compared to facilities in urban counties (p=0.005). 

Conclusion: Better county-level internet access in non-urban counties was associated with a higher likelihood of a mental health facility offering telehealth compared to urban counties. Ongoing efforts to expand internet access in rural regions are critical to ensuring access to telehealth for underserved populations.

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About this Master's Thesis

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School	Rollins School of Public Health
Department	Health Policy and Management
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health
Keyword	telehealth videoconferencing broadband telemedicine internet access mental health mental health facilities
Committee Chair / Thesis Advisor	Ilana Graetz, Emory University
Committee Members	Janet Cummings, Emory University Peter Joski, Emory University

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