Care Management Processes Used Less Often For Depression Than For Other Chronic Conditions In US Primary Care Practices

• Published in: Health Affairs Vol. 35; no. 3; pp. 394 - 400
• Main Authors: Bishop, Tara F, Ramsay, Patricia P, Casalino, Lawrence P, Bao, Yuhua, Pincus, Harold A, Shortell, Stephen M
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.03.2016
• Subjects: Ambulatory care; Asthma; Asthma - diagnosis; Asthma - therapy; Capitation; Chronic conditions; Chronic Disease - therapy; Chronic illnesses; Congestive heart failure; Correlation analysis; Cross-Sectional Studies; Databases, Factual; Depression; Depression - diagnosis; Depression - therapy; Diabetes; Diabetes mellitus; Diabetes Mellitus - diagnosis; Diabetes Mellitus - therapy; Disease; Family physicians; Female; Health care; Heart failure; Heart Failure - diagnosis; Heart Failure - therapy; Humans; Illnesses; Longitudinal Studies; Male; Management; Medical diagnosis; Medical practices; Mental depression; Outcome Assessment (Health Care); Patient Care Management - organization & administration; Patient education; Patient satisfaction; Pay for performance; Physicians; Physicians, Primary Care - statistics & numerical data; Polls & surveys; Practice Patterns, Physicians' - organization & administration; Primary care; Primary Health Care - standards; Primary Health Care - trends; Psychiatrists; Quality; Studies; Surveys and Questionnaires; United States; United States > US; USA; Mental Health/Substance Abuse; Primary Care
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2015.1068

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.