Paul N Pfeiffer, Kara Zivin, Avinash Hosanagar, Vanessa Panaite, Dara Ganoczy, H Myra Kim, Timothy Hofer, John D Piette
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引用次数: 0
Abstract
To inform the potential use of patient-reported depression symptom outcomes as measures of care quality, this study collected and analyzed longitudinal Patient Health Questionnaire (PHQ9) scores among 1,638 patients who screened positive for major depression according to a PHQ9 ≥ 10 across 29 Department of Veterans Affairs facilities. The study found baseline PHQ9, prior mental health visits, physical functioning, and treatment expectancy were consistently associated with subsequent PHQ9 outcomes. No facilities outperformed any others on PHQ9 scores at the 6-month primary endpoint, and the corresponding intra-class coefficient was ≤ .01 for the entire sample (n = 1,214) and 0.03 for the subgroup of patients with new depression episodes (n = 629). Measures of antidepressant receipt, psychotherapy, or treatment intensification were not associated with 6-month PHQ9 scores. PHQ9 outcomes are therefore unlikely to be useful as quality indicators for VA healthcare facilities due to low inter-facility variation, and new care process measures are needed to inform care for patients with chronic depression prevalent in this sample.
期刊介绍:
This journal examines the organization, financing, delivery and outcomes of behavioral health services (i.e., alcohol, drug abuse, and mental disorders), providing practical and empirical contributions to and explaining the implications for the broader behavioral health field. Each issue includes an overview of contemporary concerns and recent developments in behavioral health policy and management through research articles, policy perspectives, commentaries, brief reports, and book reviews.
This journal is the official publication of the National Council for Behavioral Health.