Virtual and In-Person Psychiatric Care: Appointment Completion and Capacity Use in a Public Mental Health Service in Peru

Objective: To compare appointment completion and offered-slot utilization between virtual and in-person outpatient psychiatric care in Peru. Methods: We conducted a retrospective ecological longitudinal study using routinely collected monthly aggregate administrative indicators from January 2022 through June 2026, with modality-month as the unit. Virtual-minus-in-person differences and 95% confidence intervals used Newey-West standard errors with 12 lags. June 2026 was partial; slot utilization was restricted to 2024-2026. Results: Across 54 paired months, mean completion was 90.9% (SD=3.9) for virtual and 83.8% (SD=2.7) for in-person care; difference +7.2 points (95% CI=4.4-9.9). Across 30 paired months, slot utilization was 73.0% (SD=8.3) and 90.5% (SD=3.8), respectively; difference -17.5 points (95% CI=-24.5 to -10.4). Sensitivity analyses were similar. Conclusions: Virtual care had higher completion but lower slot utilization. Attendance and capacity use should be evaluated separately when planning hybrid psychiatric services. Outpatient psychiatric services increasingly operate as hybrid systems in which virtual and in-person visits coexist.