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

Raghunathan appointed director of Survey Research Center

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

Next Brown Bag

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

Impact of Distance and Facility of Initial Diagnosis on Depression Treatment

Archived Abstract of Former PSC Researcher

Pfeiffer, P.N., J. Glass, K. Austin, M. Valenstein, J. McCarthy, and Kara Zivin. 2011. "Impact of Distance and Facility of Initial Diagnosis on Depression Treatment." Health Services Research, 46(3): 768-786.

Objective To assess whether distance to services or diagnosis at a hospital-based medical center compared with a community clinic influences the receipt of psychotherapy versus pharmacotherapy for depression. Data Source Veterans Affairs (VA) administrative data for 132,329 depressed veterans between October 2003 and September 2004. Study Design Multivariable logistic and multinomial regression models were used to examine the relationship between distance to the nearest mental health facility and the facility of initial depression diagnosis on receipt of any and adequate psychotherapy and/or pharmacotherapy, adjusted for patient characteristics. Principal Findings Compared with those living within 30 miles of the nearest mental health treatment facility, depressed patients living between 30 and 60 miles away had a decreased likelihood of receiving psychotherapy (OR=0.71; 95 percent CI: 0.66, 0.76) and a greater likelihood of receiving antidepressant treatment (OR=1.27; 95 percent CI: 1.22, 1.33). Initial diagnosis at a small community clinic compared with a VA medical center was not associated with a difference in receipt of any psychotherapy (OR=0.95; 95 percent CI: 0.83, 1.09), but it was associated with decreased likelihood of receiving eight or more psychotherapy visits (OR=0.46; 95 percent CI: 0.35, 0.61) or any antidepressant treatment (OR=0.69; 95 percent CI: 0.63, 0.75). Conclusions The VA and similar health systems should make efforts to insure adequate psychotherapy is provided to patients who initiate treatment at small community clinics and provide psychotherapy alternatives that may be less sensitive to travel barriers for patients living remote distances from mental health treatment. Extending services to small community clinics that support antidepressant treatment should also be considered.

DOI:10.1111/j.1475-6773.2010.01228.x (Full Text)

Country of focus: United States.

Browse | Search : All Pubs | Next