TY - JOUR
T1 - Improving care for depression
T2 - Performance measures, outcomes and insights from the health disparities collaboratives
AU - Cole, Steven
AU - Reims, Kathy
AU - Kershner, Liz
AU - McCombs, Harriet G.
AU - Little, Kevin
AU - Ford, Daniel E.
PY - 2012/8
Y1 - 2012/8
N2 - 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.
AB - 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.
KW - Chronic care
KW - Depression
KW - Depression in primary care
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=84864644720&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864644720&partnerID=8YFLogxK
U2 - 10.1353/hpu.2012.0138
DO - 10.1353/hpu.2012.0138
M3 - Article
C2 - 22864495
AN - SCOPUS:84864644720
SN - 1049-2089
VL - 23
SP - 154
EP - 173
JO - Journal of health care for the poor and underserved
JF - Journal of health care for the poor and underserved
IS - 3 SUPPL
ER -