Depression Remission Decreases Outpatient Utilization at 6 and 12 Months after Enrollment into Collaborative Care Management
| Autor: | Matthew R. Meunier, Sara Oberhelman, Kurt B. Angstman, Norman H. Rasmussen, James E. Rohrer, Daniel H. Chappell |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Leadership and Management Collaborative Care Logistic regression Ambulatory Care Facilities Young Adult Surveys and Questionnaires Chart review Confidence Intervals Odds Ratio Humans Medicine Depression (differential diagnoses) Aged Retrospective Studies Aged 80 and over Medical Audit Alcohol Use Disorders Identification Test Depression business.industry Health Policy Remission Induction Public Health Environmental and Occupational Health Mood Disorder Questionnaire Middle Aged Patient Care Management Patient Health Questionnaire Generalized anxiety Physical therapy Female business |
| Zdroj: | Population Health Management. 17:48-53 |
| ISSN: | 1942-7905 1942-7891 |
| DOI: | 10.1089/pop.2013.0004 |
| Popis: | Collaborative care management (CCM) for depression has been demonstrated to improve clinical outcomes. The impetus for this study was to determine if outpatient utilization patterns would be associated with depression outcomes. The hypothesis was that depression remission would be independently correlated with outpatient utilization at 6 and 12 months after enrollment into CCM. The study was a retrospective chart review analysis of 773 patients enrolled into CCM with 6- and 12-month follow-up data. The data set comprised baseline demographic data, patient intake self-assessment scores (Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder-7, Mood Disorder Questionnaire, and Alcohol Use Disorders Identification Test), the number of outpatient visits, and follow-up PHQ-9 scores. To control for individual patient complexity and pattern of usage, the number of outpatient visits for 6 months prior to enrollment also was measured. With a logistic regression model for outpatient visit outlier status as the dependent variable, remission at 6 months (odds ratio [OR] 0.519, CI [confidence interval] 0.349-0.770, P=0.001) and remission at 12 months (OR 0.573, CI 0.354-0.927, P=0.023) were predictive. With this inverse relationship between remission and outlier status, those patients who were not in remission had an OR of 1.928 for outpatient visit outlier status at 6 months after enrollment and an OR of 1.745 at 12 months. Patients who improved clinically to remission while in CCM had decreased odds of outlier status for outpatient utilization at 6 and 12 months when controlling for all other study variables. Improvement in health care outcomes by CCM could translate into decreased outpatient utilization for depressed patients. |
| Databáze: | OpenAIRE |
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