TY - JOUR
KW - Aged
KW - Comorbidity
KW - Delivery of Health Care, Integrated/organization & administration
KW - Depression/drug therapy
KW - Female
KW - Humans
KW - Middle Aged
KW - Questionnaires
KW - Retrospective Studies
KW - Veterans/psychology
AU - U. Sambamoorthi
AU - B. Bean-Mayberry
AU - P. A. Findley
AU - E. M. Yano
AU - R. Banerjea
A1 - 
AB - OBJECTIVE: To analyze the association between the organizational features of integration of physical and mental healthcare in womens health clinics and the diagnosis of depression among women veterans with or at risk for cardiovascular conditions (ie, diabetes mellitus, heart disease, or hypertension). STUDY DESIGN: Retrospective and observational secondary data analyses. METHODS: We studied 27,972 women veterans from 118 facilities with diagnosed cardiovascular conditions in fiscal year 2001 (FY2001) using merged Medicare claims and Veterans Health Administration (VHA) data merged with the 1999 VHA Survey of Primary Care Practices and the 2001 VHA Survey of Women Veterans Health Programs and Practices. The dependent variable was a binary indicator for diagnosed depression during FY2001 at the individual level. We used a multilevel logistic regression model to control for clustering of women veterans within facilities. Individual-level independent variables included demographics, socioeconomic characteristics, and chronic physical conditions. RESULTS: Overall, 27% of women veterans using the VHA were diagnosed as having depression in FY2001. Across facilities, rates of diagnosed depression varied from 13% to 41%. After controlling for individual-level and facility-level independent variables, women veterans who were served in separate women's health clinics with integrated physical and mental healthcare were more likely to have diagnosed depression. The adjusted odds ratio was 1.12 (95% confidence interval, 1.01-1.25). CONCLUSIONS: Existing women-specific VHA organizational features with integration of primary care and mental health seem effective in diagnosing depression. Emerging patient-centered medical home models may facilitate diagnosis and treatment of mental health issues among women with complex chronic conditions.
BT - The American Journal of Managed Care
C5 - Medical Home
CP - 9
CY - United States
IS - 9
JF - The American Journal of Managed Care
N2 - OBJECTIVE: To analyze the association between the organizational features of integration of physical and mental healthcare in womens health clinics and the diagnosis of depression among women veterans with or at risk for cardiovascular conditions (ie, diabetes mellitus, heart disease, or hypertension). STUDY DESIGN: Retrospective and observational secondary data analyses. METHODS: We studied 27,972 women veterans from 118 facilities with diagnosed cardiovascular conditions in fiscal year 2001 (FY2001) using merged Medicare claims and Veterans Health Administration (VHA) data merged with the 1999 VHA Survey of Primary Care Practices and the 2001 VHA Survey of Women Veterans Health Programs and Practices. The dependent variable was a binary indicator for diagnosed depression during FY2001 at the individual level. We used a multilevel logistic regression model to control for clustering of women veterans within facilities. Individual-level independent variables included demographics, socioeconomic characteristics, and chronic physical conditions. RESULTS: Overall, 27% of women veterans using the VHA were diagnosed as having depression in FY2001. Across facilities, rates of diagnosed depression varied from 13% to 41%. After controlling for individual-level and facility-level independent variables, women veterans who were served in separate women's health clinics with integrated physical and mental healthcare were more likely to have diagnosed depression. The adjusted odds ratio was 1.12 (95% confidence interval, 1.01-1.25). CONCLUSIONS: Existing women-specific VHA organizational features with integration of primary care and mental health seem effective in diagnosing depression. Emerging patient-centered medical home models may facilitate diagnosis and treatment of mental health issues among women with complex chronic conditions.
PP - United States
PY - 2010
SN - 1936-2692; 1088-0224
SP - 657
EP - 665
EP - 
T1 - Organization of care and diagnosed depression among women veterans
T2 - The American Journal of Managed Care
TI - Organization of care and diagnosed depression among women veterans
U1 - Medical Home
U2 - 20873953
VL - 16
VO - 1936-2692; 1088-0224
Y1 - 2010
ER -