Evidence map›Paper›PMID 36762876›Full record

ArticleAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2023

The effect of telemental versus in-person mental health consults in the emergency department on 30-day utilization and processes of care.

Jin H Han, Erica Koch, Alvin D Jeffery, Thomas J Reese, Chad Dorn, Shannon Pugh, Melissa Rubenstein, Jo Ellen Wilson, Corey Campbell, Michael J Ward

Open access · bronzeAbstract read
In one paragraph

Article in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Jin H HanDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0003-0384-210X
Erica KochDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-7997-9933
Alvin D JefferyVanderbilt University School of Nursing, Nashville, Tennessee, USA.
Thomas J ReeseDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Chad DornDepartment of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Shannon PughDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Melissa RubensteinDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Jo Ellen WilsonGeriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Corey CampbellPsychiatric Services, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Michael J WardDepartment of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-4561-2946
VA Tennessee Valley Healthcare System · USVanderbilt University Medical Center · USVanderbilt University · US

Funding

The Vanderbilt Institute for Clinical and Translational Research (VICTR)UL1TR000445 · NCATS · VANDERBILT UNIVERSITY MEDICAL CENTER · PI BERNARD, GORDON RAPHAEL · 2012 to 2016
$41.4M
Early Cognitive Training and Rehabilitation to Prevent Cognitive Decline in Older Hospitalized Adults with DeliriumR01AG065249 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HAN, JIN HO, JACKSON, JAMES C. · 2020 to 2024
$2.9M
AHRQ HHS K12 HS026395NCATS NIH HHS UL1 TR000445NHLBI NIH HHS L30 HL159795NIA NIH HHS R01 AG065249
6 · The paper itself

Abstract

objectivesWe sought to characterize how telemental health (TMH) versus in-person mental health consults affected 30-day postevaluation utilization outcomes and processes of care in Veterans presenting to the emergency department (ED) and urgent care clinic (UCC) with acute psychiatric complaints.

methodsThis exploratory retrospective cohort study was conducted in an ED and UCC located in a single Veterans Affairs system. A mental health provider administered TMH via iPad. The primary outcome was a composite of return ED/UCC visits, rehospitalizations, or death within 30 days. The following processes of care were collected during the index visit: changes to home psychiatric medications, admission, involuntary psychiatric hold placement, parenteral benzodiazepine or antipsychotic medication use, and physical restraints or seclusion. Data were abstracted from the Veterans Affairs electronic health record and the Clinical Data Warehouse. Multivariable logistic regression was performed. Adjusted odds ratios (aORs) with their 95% confidence intervals (95% CIs) were reported.

resultsOf the 496 Veterans in this analysis, 346 (69.8%) received TMH, and 150 (30.2%) received an in-person mental health evaluation. There was no significant difference in the primary outcome of 30-day return ED/UCC, rehospitalization, or death (aOR 1.47, 95% CI 0.87-2.49) between the TMH and in-person groups. TMH was significantly associated with increased ED/UCC length of stay (aOR 1.46, 95% CI 1.03-2.06) and decreased use of involuntary psychiatric holds (aOR 0.42, 95% CI 0.23-0.75). There were no associations between TMH and the other processes-of-care outcomes.

conclusionsTMH was not significantly associated with the 30-day composite outcome of return ED/UCC visits, rehospitalizations, and death compared with traditional in-person mental health evaluations. TMH was significantly associated with increased ED/UCC length of stay and decreased odds of placing an involuntary psychiatric hold. Future studies are required to confirm these findings and, if confirmed, explore the potential mechanisms for these associations.

Indexed as

Ambulatory Care FacilitiesMental HealthEmergency Service, HospitalHumansReferral and ConsultationRetrospective Studies

Identifiers

PMID36762876
PMCPMC11106754
OpenAlexW4319822391

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.