TY - VIDEO
KW - Case Management
KW - Depression
KW - health care cost
KW - Health Care Costs
KW - Human
KW - integrated care intervention
KW - Integrated Services
KW - Major Depression
KW - medication management outcome
KW - Primary Health Care
AU - Robert William Bremer
A1 - 
AB - Integrated Care (IC) has been proposed as a treatment model to improve the recognition and treatment of depression in primary care. The primary objectives of this thesis were to evaluate (1) changes in the rates of primary care, mental health department, and medical sub-specialty services, (2) the total cost of health services between groups, and (3) the relationship among adherence to antidepressants and depression outcomes as a result of an IC intervention. The IC model in this study was implemented in a Family Medicine clinic and consisted of a full-time psychologist based in the clinic to provide direct care and consultation to primary care physicians. The study population was 86 patients in the IC group from the Family Medicine clinic and 81 patients in a Screening Only group from the Internal Medicine clinic. Evaluation of the rates of primary care, mental health department, and medical sub-specialties showed no differences between groups at any of the four post-intervention time points. Health services costs included in the analysis showed that there was a significant decrease in costs between groups at three of the four time points, but comparison of costs for all time points from baseline was not significant. Analysis of antidepressant medication management showed no differences between groups in the improvement of adequate antidepressant management. There were also no differences in the improvement of depression severity scores between patients who did received adequate antidepressant management and those patients who did not. There was however, significant improvement in depression severity scores in the IC group, among a subset of patients who received adequate antidepressant management. These findings support the conclusion that costs for the IC intervention were statistically equivalent to a group of patients who only received screening, and that the benefit of the IC intervention involve some other important factor other than improving adequate antidepressant medication management. The specific processes that led to improvements in QPD scores among the group that had adequate antidepressant medication management needs to be explored further. Further study from other similar intervention is needed to more strongly support these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
BT - Dissertation Abstracts International: Section B: The Sciences and Engineering
C4 - This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.
C5 - Financing & Sustainability; Grey Literature
CP - 7-B
CY - US
IS - 7-B
JF - Dissertation Abstracts International: Section B: The Sciences and Engineering
N2 - Integrated Care (IC) has been proposed as a treatment model to improve the recognition and treatment of depression in primary care. The primary objectives of this thesis were to evaluate (1) changes in the rates of primary care, mental health department, and medical sub-specialty services, (2) the total cost of health services between groups, and (3) the relationship among adherence to antidepressants and depression outcomes as a result of an IC intervention. The IC model in this study was implemented in a Family Medicine clinic and consisted of a full-time psychologist based in the clinic to provide direct care and consultation to primary care physicians. The study population was 86 patients in the IC group from the Family Medicine clinic and 81 patients in a Screening Only group from the Internal Medicine clinic. Evaluation of the rates of primary care, mental health department, and medical sub-specialties showed no differences between groups at any of the four post-intervention time points. Health services costs included in the analysis showed that there was a significant decrease in costs between groups at three of the four time points, but comparison of costs for all time points from baseline was not significant. Analysis of antidepressant medication management showed no differences between groups in the improvement of adequate antidepressant management. There were also no differences in the improvement of depression severity scores between patients who did received adequate antidepressant management and those patients who did not. There was however, significant improvement in depression severity scores in the IC group, among a subset of patients who received adequate antidepressant management. These findings support the conclusion that costs for the IC intervention were statistically equivalent to a group of patients who only received screening, and that the benefit of the IC intervention involve some other important factor other than improving adequate antidepressant medication management. The specific processes that led to improvements in QPD scores among the group that had adequate antidepressant medication management needs to be explored further. Further study from other similar intervention is needed to more strongly support these findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
PP - US
PY - 2004
SN - 0419-4217
SP - 3183
EP - 3183
EP - 
T1 - Utilization, cost, and medication management outcomes of an integrated care intervention for depression
T2 - Dissertation Abstracts International: Section B: The Sciences and Engineering
TI - Utilization, cost, and medication management outcomes of an integrated care intervention for depression
U1 - Financing & Sustainability; Grey Literature
U4 - This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.
VL - 64
VO - 0419-4217
Y1 - 2004
ER -