Improving care for depression: Performance measures, outcomes and insights from the health disparities collaboratives

Steven Cole, Kathy Reims, Liz Kershner, Harriet G. McCombs, Kevin Little, Daniel E. Ford

Research output: Contribution to journalArticle

Abstract

This paper reports 10 measures, outcomes, and insights from HRSA Depression Health Disparities Collaboratives, representing attempts to accelerate evidence-based guidelines into practice. Te authors analyze interviews with leadership of high-performing centers. Monthly data was submitted on 38,000 patients from 94 centers. Regression analyses were conducted to identify process measures predictive of better outcomes. Results indicated that these 10 measures of care were effective in guiding and quantifying improved outcomes. One measure, early and sustained response (ESR), proved particularly useful as it reffects long term outcomes. Regression analyses identified one process measure (Patient Health Questionnaire Reassessment) strongly associated with improved clinical outcomes (n=37, R2=44%). Interviews identified 18 process changes deemed pivotal for meaningful change. In sum, well-designed approaches utilizing proven improvement methodologies resulted in substantial enhancements in depression care. This approach and these measures, especially ESR and PHQ Reassessment, may improve depression care in other under-served settings.

Original languageEnglish (US)
Pages (from-to)154-173
Number of pages20
JournalJournal of health care for the poor and underserved
Volume23
Issue number3 SUPPL
StatePublished - Aug 1 2012

Keywords

  • Chronic care
  • Depression
  • Depression in primary care
  • Primary care

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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