A Comparison of Collaborative Care Outcomes in Two Health Care Systems: VA Clinics and Federally Qualified Health Centers
| Autor: | Dinesh Mittal, John C. Fortney, Teresa J. Hudson, Jeffrey M. Pyne, John M. Ray, Kathleen M. Grubbs |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Treatment outcome Collaborative Care Ambulatory Care Facilities Article 03 medical and health sciences 0302 clinical medicine Outcome Assessment Health Care Health care medicine Humans health care economics and organizations Depression (differential diagnoses) Aged Veterans Depressive Disorder business.industry Community Health Centers Middle Aged Symptom reduction Telemedicine United States humanities 030227 psychiatry United States Department of Veterans Affairs Psychiatry and Mental health Family medicine Usual care Female Rural Health Services business 030217 neurology & neurosurgery |
| Zdroj: | Psychiatric Services. 69:431-437 |
| ISSN: | 1557-9700 1075-2730 |
| DOI: | 10.1176/appi.ps.201700067 |
| Popis: | OBJECTIVE: Collaborative care for depression results in symptom reduction when compared with usual care. No studies have systematically compared collaborative care outcomes between veterans treated at Veterans Affairs (VA) clinics and civilians treated at publicly funded federally qualified health centers (FQHCs) after controlling for demographic and clinical characteristics. METHODS: Data from two randomized controlled trials that used a similar collaborative care intervention for depression were combined to conduct post hoc analyses (N=759). The Telemedicine-Enhanced Antidepressant Management intervention was delivered in VA community-based outpatient clinics (CBOCs), and the Outreach Using Telemedicine for Rural Enhanced Access in Community Health intervention was delivered in FQHCs. Multivariate logistic regression was used to determine whether veteran status moderated the effect of the intervention on treatment response (>50% reduction in symptoms). RESULTS: There was a significant main effect for intervention (odds ratio [OR]=5.23, p |
| Databáze: | OpenAIRE |
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