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Erschienen in:
01.03.2013 | Original Research
Integrated Care: Treatment Initiation Following Positive Depression Screens
Erschienen in: Journal of General Internal Medicine | Ausgabe 3/2013
Einloggen, um Zugang zu erhaltenABSTRACT
BACKGROUND
Primary Care-Mental Health Integration (PC-MHI) may improve mental health services access and continuity of care.
OBJECTIVE
To assess whether receipt of integrated PC-MHI services on the date of an initial positive depression screen influences receipt of depression treatment among primary care (PC) patients in the Veterans Health Administration.
DESIGN
Retrospective cohort study.
SUBJECTS
Thirty-six thousand, two hundred and sixty-three PC patients with positive depression screens between October 1, 2009 and September 30, 2010.
MAIN MEASURES
Subjects were assessed for depression diagnosis and initiation of antidepressants or psychotherapy on the screening day, within 12 weeks, and within 6 months. Among individuals with PC encounters on the screening day, setting of services received that day was categorized as PC only, PC-MHI, or Specialty Mental Health (SMH). Using multivariable generalized estimating equations (GEE) logistic regression, we assessed likelihood of treatment initiation, adjusting for demographic and clinical measures, including depression screening score.
KEY RESULTS
Patients who received same-day PC-MHI services were more likely to initiate psychotherapy (OR: 8.16; 95 % CI: 6.54–10.17) and antidepressant medications (OR: 2.33, 95 % CI: 2.10–2.58) within 12 weeks than were those who received only PC services on the screening day.
CONCLUSIONS
Receipt of same-day PC-MHI may facilitate timely receipt of depression treatment.