Home > Publications . Search All . Browse All . Country . Browse PSC Pubs . PSC Report Series

PSC In The News

RSS Feed icon

Lam looks at population and development in next 15 years in UN commission keynote address

Mitchell et al. find harsh family environments may magnify disadvantage via impact on 'genetic architecture'

Frey says Arizona's political paradoxes explained in part by demography

Highlights

PSC newsletter spring 2014 issue now available

Kusunoki wins faculty seed grant award from Institute for Research on Women and Gender

2014 PAA Annual Meeting, May 1-3, Boston

USN&WR ranks Michigan among best in nation for graduate education in sociology, public health, economics

Next Brown Bag

Monday, April 21
Grant Miller: Managerial Incentives in Public Service Delivery

Five-Year Impact of Quality Improvement for Depression - Results of a Group-Level Randomized Controlled Trial

Archived Abstract of Former PSC Researcher

Wells, K., C. Sherbourne, Michael Schoenbaum, S. Ettner, N. Duan, J. Miranda, J. Unutzer, and L. Rubenstein. 2004. "Five-Year Impact of Quality Improvement for Depression - Results of a Group-Level Randomized Controlled Trial." Archives of General Psychiatry, 61(4): 378-386.

Background: Quality improvement (QI) programs for depressed primary care patients can improve health outcomes for 6 to 28 months; effects for longer than 28 months are unknown. Objective: To assess how QI for depression affects health outcomes, quality of care, and health outcome disparities at 57-month follow-up. Design: A group-level randomized controlled trial. Setting: Forty-six primary care practices in 6 managed care organizations. Patients: Of 1356 primary care patients who screened positive for depression and enrolled in the trial, 991 (73%, including 451 Latinos and African Americans) completed 57-month telephone follow-up. Interventions: Clinics were randomly assigned to usual care or to I of 2 QI programs supporting QI teams, provider training, nurse assessment, and patient education, plus resources to support medication management (QI-meds) or psychotherapy (QI-therapy) for 6 to 12 months. Main Outcome Measures: Probable depressive disorder in the previous 6 months, mental health-related quality of life in the previous 30 days, primary care or mental health specialty visits, counseling or antidepressant medications in the previous 6 months, and unmet need, defined as depressed but not receiving appropriate care. Results: Combined QI-meds and QI-therapy, relative to usual care, reduced the percentage of participants with probable disorder at 5 years by 6.6 percentage points (P=.04). QI-therapy improved health outcomes and reduced unmet need for appropriate care among Latinos and African Americans combined but provided few long-term benefits among whites, reducing outcome disparities related to usual care (P=.04 for QI-ethnicity interaction for probable depressive disorder). Conclusions: Programs for QI for depressed primary care patients implemented by managed care practices can improve health outcomes 5 years after implementation and reduce health outcome disparities by markedly improving health outcomes and unmet need for appropriate care among Latinos and African Americans relative to whites; thus, equity was improved in the long run.

Browse | Search : All Pubs | Next