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Clinical improvement associated with conformance to HEDIS-based depression care
Kathryn Rost1, L Miriam Dickinson, John Fortney
1Center for Studies in Family Medicine, Department of Family Medicine, University of Colorado Health Sciences Center, UCHSC at Fitzsimons, P.O. Box 6508 Mail Stop F496, Aurora, CO 80045-0508, USA. Kathryn.Rost@UCHSC.edu
Mental Health Services Research
|June 25, 2005
Summary
Employers need a quality metric for depression treatment. A new indicator shows that 7% of those needing care received it, and this care predicted significant depression improvement.
Area of Science:
- Health Services Research
- Clinical Quality Measurement
- Mental Health Services
Background:
- Employers require a reliable metric to assess depression treatment quality.
- Existing quality indicators may not accurately reflect the proportion of the population receiving adequate care.
- A valid metric must predict clinical improvement in patients with depression.
Purpose of the Study:
- To construct and test an administrative database indicator for depression treatment quality.
- To evaluate the indicator's ability to measure high-quality antidepressant medication management.
- To determine if the indicator predicts clinical improvement in employed patients.
Main Methods:
- Developed an administrative database indicator based on Healthcare Effectiveness Data and Information Set (HEDIS) criteria.
- Applied the indicator to assess antidepressant medication management in 230 employed patients across five health plans.
- Analyzed the association between indicator conformance and changes in depression severity over one year.
Main Results:
- The indicator identified 7.0% of the population in need receiving adequate depression treatment.
- Conformance to the indicator criteria was linked to a 23.0% improvement in depression severity.
- This improvement was statistically significant (p = .02) over a 1-year period.
Conclusions:
- Administrative database indicators that predict clinical improvement in depression are uncommon.
- Calculating existing depression indicators for the 'population in need' is crucial for a valid employer purchaser metric.
- The developed indicator shows promise for measuring and improving depression care quality.