Care Management Processes Used Less Often For Depression Than For Other Chronic Conditions In US Primary Care Practices
- Tara F. Bishop ( [email protected] ) is an associate professor in the Department of Healthcare Policy and Research at Weill Cornell Medical College, in New York City.
- Patricia P. Ramsay is a research specialist and administrative director of the Center for Healthcare Organizational and Innovation Research (CHOIR) in the School of Public Health, University of California, Berkeley.
- Lawrence P. Casalino is the Livingston Farrand Professor of Public Health and chief of the Division of Health Policy and Economics in the Department of Healthcare Policy and Research, at Weill Cornell Medical College.
- Yuhua Bao is an associate professor of healthcare policy and research at Weill Cornell Medical College.
- Harold A. Pincus is a professor and vice chair of Columbia Psychiatry, Columbia University; director of quality and outcomes research at New York-Presbyterian Hospital, and codirector of the Irving Institute for Clinical and Translational Research at Columbia University, all in New York City. He also is a senior scientist at the RAND Corporation.
- Stephen M. Shortell is the Blue Cross of California Distinguished Professor, a professor of organization behavior, director of CHOIR, and dean emeritus, all at the School of Public Health, University of California, Berkeley.
Abstract
Primary care physicians play an important role in the diagnosis and management of depression. Yet little is known about their use of care management processes for depression. Using national survey data for the period 2006–13, we assessed the use of five care management processes for depression and other chronic illnesses among primary care practices in the United States. We found significantly less use for depression than for asthma, congestive heart failure, or diabetes in 2012–13. On average, practices used fewer than one care management process for depression, and this level of use has not changed since 2006–07, regardless of practice size. In contrast, use of diabetes care management processes has increased significantly among larger practices. These findings may indicate that US primary care practices are not well equipped to manage depression as a chronic illness, despite the high proportion of depression care they provide. Policies that incentivize depression care management, including additional quality metrics, should be considered.
