Implications of broadband internet access for telehealth provision at outpatient mental health facilities Restricted; Files Only

Neenan, Rachel (Spring 2022)

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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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