Disparities and Medical Expenditure Implications in Pediatric Tele-Mental Health Services During the COVID-19 Pandemic in Mississippi.

Tele-mental health (TMH) services, including both mental and behavioral healthcare (MBH) services, emerged as a cornerstone in delivering pediatric mental healthcare during the coronavirus disease 2019 (COVID-19) pandemic, yet their utilization and effects on healthcare resource utilization (HCRU) and medical expenditures remain unclear. To bridge the gap, this study aims to investigate the association between TMH utilization and sociodemographic factors and assess its associated HCRU and medical expenditures within a pediatric population in Mississippi. Studying 1,972 insured pediatric patients who accessed outpatient MBH services at the study institution between January 2020 and June 2023, age, race, insurance type, rural residency, and household income were identified as key determinants of TMH utilization. Adjusting for sociodemographics, TMH utilization was associated with 122% more MBH-associated outpatient visits and 36% higher related medical expenditures, but 27% less overall medical expenditures. This study reveals sociodemographic disparities in pediatric TMH utilization, highlights its role in augmenting outpatient mental healthcare access, and shows its potential for cost savings. Future efforts should aim at fostering more digitally inclusive, equitable, and affordable pediatric mental healthcare services.

Tele-Mental Health Service: Unveiling the Disparity and Impact on Healthcare Access and Expenditures during the COVID-19 Pandemic in Mississippi.

During the COVID-19 pandemic, tele-mental health (TMH) was a viable approach for providing accessible mental and behavioral health (MBH) services. This study examines the sociodemographic disparities in TMH utilization and its effects on healthcare resource utilization (HCRU) and medical expenditures in Mississippi. Utilizing a cohort of 6787 insured adult patients at the University of Mississippi Medical Center and its affiliated sites between January 2020 and June 2023, including 3065 who accessed TMH services, we observed sociodemographic disparities between TMH and non-TMH cohorts. The TMH cohort was more likely to be younger, female, White/Caucasian, using payment methods other than Medicare, Medicaid, or commercial insurers, residing in rural areas, and with higher household income compared to the non-TMH cohort. Adjusting for sociodemographic factors, TMH utilization was associated with a 190% increase in MBH-related outpatient visits, a 17% increase in MBH-related medical expenditures, and a 12% decrease in all-cause medical expenditures (all p < 0.001). Among rural residents, TMH utilization was associated with a 205% increase in MBH-related outpatient visits and a 19% decrease in all-cause medical expenditures (both p < 0.001). This study underscores the importance of addressing sociodemographic disparities in TMH services to promote equitable healthcare access while reducing overall medical expenditures.

Duration of cough in acute upper respiratory tract infections.

OBJECTIVE: To determine the duration of cough in patients without pre-existing respiratory problems presenting to general practitioners with acute upper respiratory tract infections (URTIs). METHOD: Patients without chronic chest problems who presented to two general practices with an URTI during the winter of 1999 were surveyed to assess the duration of cough. RESULTS: One hundred and seventy-nine patients were recruited, of whom 131 could be followed until their cough ceased. Of these, 93% developed a cough, 78% coughed for at least one week, 58% for at least two weeks, 35% for three weeks, and one continued into the tenth week. CONCLUSION: The acute cough associated with an URTI often continues for several weeks. There may be benefits from educating the community and medical profession about this natural history.