Show simple item record

dc.contributor.authorCharbonneau, Andrea
dc.contributor.authorRosen, Amy K.
dc.contributor.authorOwen, Richard R.
dc.contributor.authorSpiro, Avron III
dc.contributor.authorAsh, Arlene S.
dc.contributor.authorMiller, Donald R.
dc.contributor.authorKazis, Lewis
dc.contributor.authorKader, Boris
dc.contributor.authorCunningham, Fran
dc.contributor.authorBerlowitz, Dan R.
dc.date2022-08-11T08:10:42.000
dc.date.accessioned2022-08-23T17:17:17Z
dc.date.available2022-08-23T17:17:17Z
dc.date.issued2004-05-29
dc.date.submitted2010-07-01
dc.identifier.citationMed Care. 2004 Jun;42(6):522-31. <a href="http://journals.lww.com/lww-medicalcare/Abstract/2004/06000/Monitoring_Depression_Care__In_Search_of_an.4.aspx">Link to article on publisher's site</a>
dc.identifier.issn0025-7079 (Linking)
dc.identifier.pmid15167320
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47593
dc.description.abstractBACKGROUND: Linking process and outcomes is critical to accurately estimating healthcare quality and quantifying its benefits. OBJECTIVES: The objective of this study was to explore the relationship of guideline-based depression process measures with subsequent overall and psychiatric hospitalizations. RESEARCH DESIGN: This is a retrospective cohort study during which we used administrative and centralized pharmacy records for sample identification, derivation of guideline-based process measures (antidepressant dosage and duration adequacy), and subsequent hospitalization ascertainment. Depression care was measured from June 1, 1999, through August 31, 1999. We used multivariable regression to evaluate the link between depression care and subsequent overall and psychiatric hospitalization, adjusting for patient age, race, sex, socioeconomic status, comorbid illness, and hospitalization in the prior 12 months. SUBJECTS: We studied a total of 12,678 patients from 14 Northeastern VHA hospitals. RESULTS: We identified adequate antidepressant dosage in 90% and adequate duration in 45%. Those with adequate duration of antidepressants were less likely to be hospitalized in the subsequent 12 months than those with inadequate duration (odds ratio [OR],.90; 95% confidence interval [CI], .81-1.00). Those with adequate duration of antidepressants were less likely to have a psychiatric hospitalization in the subsequent 12 months than those with inadequate duration (OR, .82; 95% CI, .69-.96). We did not demonstrate a significant link between dosage adequacy and subsequent overall or psychiatric hospitalization. CONCLUSIONS: Guideline-based depression process measures derived from centralized data sources offer an important method of depression care surveillance. Their accuracy in capturing depression care quality is supported by their link to healthcare utilization. Further work is needed to assess the effect of implementing these quality indicators on depression care.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=15167320&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://journals.lww.com/lww-medicalcare/Abstract/2004/06000/Monitoring_Depression_Care__In_Search_of_an.4.aspx
dc.subjectAdult
dc.subjectAged
dc.subjectAntidepressive Agents
dc.subjectCohort Studies
dc.subjectComorbidity
dc.subjectDepressive Disorder
dc.subject*Drug Utilization Review
dc.subjectFemale
dc.subjectHospitalization
dc.subjectHospitals, Psychiatric
dc.subjectHospitals, Veterans
dc.subjectHumans
dc.subjectLogistic Models
dc.subjectMale
dc.subjectMental Health Services
dc.subjectMiddle Aged
dc.subjectNew England
dc.subjectNew York
dc.subjectOutcome and Process Assessment (Health Care)
dc.subject*Quality Indicators, Health Care
dc.subjectUnited States
dc.subjectUnited States Department of Veterans Affairs
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleMonitoring depression care: in search of an accurate quality indicator
dc.typeJournal Article
dc.source.journaltitleMedical care
dc.source.volume42
dc.source.issue6
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/722
dc.identifier.contextkey1378869
html.description.abstract<p>BACKGROUND: Linking process and outcomes is critical to accurately estimating healthcare quality and quantifying its benefits.</p> <p>OBJECTIVES: The objective of this study was to explore the relationship of guideline-based depression process measures with subsequent overall and psychiatric hospitalizations.</p> <p>RESEARCH DESIGN: This is a retrospective cohort study during which we used administrative and centralized pharmacy records for sample identification, derivation of guideline-based process measures (antidepressant dosage and duration adequacy), and subsequent hospitalization ascertainment. Depression care was measured from June 1, 1999, through August 31, 1999. We used multivariable regression to evaluate the link between depression care and subsequent overall and psychiatric hospitalization, adjusting for patient age, race, sex, socioeconomic status, comorbid illness, and hospitalization in the prior 12 months.</p> <p>SUBJECTS: We studied a total of 12,678 patients from 14 Northeastern VHA hospitals.</p> <p>RESULTS: We identified adequate antidepressant dosage in 90% and adequate duration in 45%. Those with adequate duration of antidepressants were less likely to be hospitalized in the subsequent 12 months than those with inadequate duration (odds ratio [OR],.90; 95% confidence interval [CI], .81-1.00). Those with adequate duration of antidepressants were less likely to have a psychiatric hospitalization in the subsequent 12 months than those with inadequate duration (OR, .82; 95% CI, .69-.96). We did not demonstrate a significant link between dosage adequacy and subsequent overall or psychiatric hospitalization.</p> <p>CONCLUSIONS: Guideline-based depression process measures derived from centralized data sources offer an important method of depression care surveillance. Their accuracy in capturing depression care quality is supported by their link to healthcare utilization. Further work is needed to assess the effect of implementing these quality indicators on depression care.</p>
dc.identifier.submissionpathqhs_pp/722
dc.contributor.departmentDepartment of Quantitative Health Sciences
dc.source.pages522-31


This item appears in the following Collection(s)

Show simple item record