Evaluating Depression Care Management in a Community Setting: Main Outcomes for a Medicaid HMO Population with Multiple Medical and Psychiatric Comorbidities

Autor: Jeanette A. Waxmonsky, Marshall Thomas, Alexis Giese, Steve Zyzanski, L. Miriam Dickinson, Gretchen Flanders McGinnis, Paul Nutting
Jazyk: angličtina
Rok vydání: 2012
Předmět:
Zdroj: Depression Research and Treatment, Vol 2012 (2012)
Druh dokumentu: article
ISSN: 2090-1321
2090-133X
DOI: 10.1155/2012/769298
Popis: The authors describe the implementation of a depression care management (DCM) program at Colorado Access, a public sector health plan, and describe the program’s clinical and system outcomes for members with chronic medical conditions. High medical risk, high cost Medicaid health plan members were identified and systematically screened for depression. A total of 370 members enrolled in the DCM program. Longitudinal analyses revealed significantly reduced depression severity scores at 3, 6, and 12 months after intervention as compared to baseline depression scores. At 12 months, 56% of enrollees in the DCM program had either a 50% reduction in PHQ-9 scores or a PHQ-9 score < 10. Longitudinal economic analyses comparing 12 months before and after intervention revealed a significant but modest increase in ER visits, outpatient office visits, and overall medical and pharmacy costs when adjusted for months enrolled in DCM. Limitations and recommendations for the integrated depression care management are discussed.
Databáze: Directory of Open Access Journals