TY - JOUR
KW - Aged
KW - Depression/diagnosis
KW - Ethnic Groups
KW - Female
KW - Geriatric Assessment/methods
KW - Humans
KW - Interviews as Topic
KW - Male
KW - Physician's Practice Patterns
KW - Physician-Patient Relations
KW - Physicians, Family
KW - Sex Factors
KW - Socioeconomic Factors
KW - Videotape Recording
AU - M. Tai-Seale
AU - R. Bramson
AU - D. Drukker
AU - M. L. Hurwicz
AU - M. Ory
AU - T. Tai-Seale
AU - R. Street
AU - M. A. Cook
A1 - 
AB - OBJECTIVE: The objective of this study was to examine primary care physicians' propensity to assess their elderly patients for depression using data from videotapes and patient and physician surveys. STUDY DESIGN: An observational study was informed by surveys of 389 patients and 33 physicians, and 389 videotapes of their clinical interactions. Secondary quantitative analyses used video data scored by the Assessment of Doctor-Elderly Patient Transactions system regarding depression assessment. A random-effects logit model was used to analyze the effects of patient health, competing demands, and racial and gender concordance on physicians' propensity to assess elderly patients for depression. RESULTS: Physicians assessed depression in only 14% of the visits. The use of formal depression assessment tools occurred only 3 times. White patients were almost 7 times more likely than nonwhite patients to be assessed for depression (odds ratio [OR], 6.9; P < 0.01). Depression assessment was less likely if the patient functioned better emotionally (OR, 0.95; P < 0.01). The propensity of depression assessment was higher in visits that covered multiple topics (OR, 1.3; P < 0.01) contrary to the notion of competing demands crowding out mental health services. Unexpectedly, depression assessment was less likely to occur in gender and racially concordant patient-physician dyads. CONCLUSIONS: Primary care physicians assessed their elderly patients for depression infrequently. Reducing the number of topics covered in visits and matching patients and physicians based on race and gender may be counterproductive to depression detection. Informed by videotapes and surveys, our findings offer new insights on the actual care process and present conclusions that are different from studies based on administrative or survey data alone.
BT - Medical care
C5 - Education & Workforce; Healthcare Disparities
CP - 12
CY - United States
IS - 12
JF - Medical care
N2 - OBJECTIVE: The objective of this study was to examine primary care physicians' propensity to assess their elderly patients for depression using data from videotapes and patient and physician surveys. STUDY DESIGN: An observational study was informed by surveys of 389 patients and 33 physicians, and 389 videotapes of their clinical interactions. Secondary quantitative analyses used video data scored by the Assessment of Doctor-Elderly Patient Transactions system regarding depression assessment. A random-effects logit model was used to analyze the effects of patient health, competing demands, and racial and gender concordance on physicians' propensity to assess elderly patients for depression. RESULTS: Physicians assessed depression in only 14% of the visits. The use of formal depression assessment tools occurred only 3 times. White patients were almost 7 times more likely than nonwhite patients to be assessed for depression (odds ratio [OR], 6.9; P < 0.01). Depression assessment was less likely if the patient functioned better emotionally (OR, 0.95; P < 0.01). The propensity of depression assessment was higher in visits that covered multiple topics (OR, 1.3; P < 0.01) contrary to the notion of competing demands crowding out mental health services. Unexpectedly, depression assessment was less likely to occur in gender and racially concordant patient-physician dyads. CONCLUSIONS: Primary care physicians assessed their elderly patients for depression infrequently. Reducing the number of topics covered in visits and matching patients and physicians based on race and gender may be counterproductive to depression detection. Informed by videotapes and surveys, our findings offer new insights on the actual care process and present conclusions that are different from studies based on administrative or survey data alone.
PP - United States
PY - 2005
SN - 0025-7079; 0025-7079
SP - 1217
EP - 1224
EP - 
T1 - Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data
T2 - Medical care
TI - Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data
U1 - Education & Workforce; Healthcare Disparities
U2 - 16299433
VL - 43
VO - 0025-7079; 0025-7079
Y1 - 2005
ER -