Related Experiment Videos
Targeting quality improvement activities for depression. Implications of using administrative data
M Valenstein1, T Ritsema, L Green
1Serious Mental Illness Treatment Research and Evaluation Center, Health Services Research and Development, Department of Veterans Affairs Medical Center, Ann Arbor, MI 48113-0170, USA. marciav@umich.edu
The Journal of Family Practice
|August 18, 2000
Summary
Administrative data identify primary care patients with depression who often have severe, recurrent disorders. Quality improvement programs may need intensive interventions, as standard care leaves many patients symptomatic and functionally impaired.
Area of Science:
- Primary care research
- Mental health services research
- Health services research
Background:
- Healthcare organizations use administrative data to identify patients with depression for quality improvement (QI).
- Limited knowledge exists on the characteristics of patients identified via administrative data and their specific QI needs.
- This study characterizes patients identified through administrative data in two family practice clinics.
Purpose of the Study:
- To describe the clinical characteristics and outcomes of primary care patients with depression identified through administrative data.
- To inform the development of targeted quality improvement (QI) initiatives for this population.
Main Methods:
- Identified patients aged 18-65 with depression using administrative/encounter data over 16 months.
- Administered the Primary Care Evaluation of Mental Disorders, Depression Outcomes Modules (including SF-36), SCL-25, and AUDIT to 103 participants.
- Conducted follow-up assessments with 83 patients at a median of 7 months.
Main Results:
- 85% met criteria for a depressive disorder; others had high SCL-25 symptom levels.
- 77% reported recurrent depression, and 60% had chronic depression.
- Most patients improved, but 60% remained symptomatic with significant functional deficits (SF-36).
Conclusions:
- QI programs using administrative data will identify patients with severe, recurrent depression.
- Standard treatments, even with QI, may not fully resolve symptoms or functional deficits.
- QI initiatives should consider intensive alternatives beyond standard care monitoring for this cohort.