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Poster #77 - Telehealth for Substance Use Disorders: Informing Policy Through Utilization Patterns in Federally Qualified Health Centers
Friday, November 14, 5:00 to 6:30pm, Property: Hyatt Regency Seattle, Floor: 7th Floor, Room: 710 - Regency BallroomAbstract
Objective: To examine utilization patterns of telehealth for substance use disorder (tele-SUD) treatment among Federally Qualified Health Centers (FQHCs) and assess differences between urban and rural settings.
Study Setting and Design: This cross-sectional study analyzed tele-SUD utilization among FQHCs from 2019 to 2023. Logistic regression examined factors associated with any tele-SUD use, while negative binomial regression examined service volume among FQHCs providing tele-SUD, adjusting for SUD full-time equivalent (FTE) staffing and patient population.
Data Sources and Analytic Sample: FQHC-reported data from the Uniform Data System (UDS) from 2019 to 2023 were used to examine annual tele-SUD visit volumes, along with FQHC patient demographics and organizational characteristics. The analysis included 3,864 FQHC-year observations for the full sample, with 603 FQHC-year observations reporting any tele-SUD visits during the study period.
Principal Findings: The percentage of FQHCs reporting any tele-SUD visits increased from 0.7% in 2019 to 47% in 2021, before declining to 28.6% in 2023. Rural setting was not associated with reporting tele-SUD visits (OR = 0.87, p = 0.221). However, among FQHCs reporting tele-SUD visits, rural sites had 67% lower tele-SUD visit volumes than urban FQHCs (IRR = 0.33, p < 0.001). Higher SUD FTE staffing was associated with reporting any tele-SUD visits (OR = 1.64, p < 0.001) but not with volume among users (IRR = 0.99, p = 0.008).
Conclusions: Tele-SUD use peaked at nearly half of FQHCs in 2021 but fell below one-third by 2023. While rural and urban FQHCs were equally likely to report any use, rural sites had much lower volumes. The concentration of tele-SUD visits among a minority of FQHCs and persistent volume disparities suggest factors beyond federal regulatory policy influence utilization patterns.