TY - JOUR
KW - Cost-Benefit Analysis
KW - Depression/economics/therapy
KW - Depressive Disorder/economics/prevention & control
KW - Female
KW - Health Care Costs
KW - Health Services Research
KW - Humans
KW - Male
KW - Primary Health Care/economics/standards
KW - Quality Assurance, Health Care
KW - Quality-Adjusted Life Years
KW - United States
AU - J. M. Pyne
AU - K. M. Rost
AU - M. Zhang
AU - D. K. Williams
AU - J. Smith
AU - J. Fortney
A1 - 
AB - OBJECTIVE: To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN: Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. SETTING: Primary care practices located in 10 states across the United States. PATIENTS/PARTICIPANTS: Two hundred eleven patients beginning a new treatment episode for major depression. INTERVENTIONS: Training the primary care team to assess, educate, and monitor depressed patients during the acute and continuation stages of their depression treatment episode over 1 year. MEASUREMENTS AND MAIN RESULTS: Cost-effectiveness was measured by calculating incremental (enhanced minus usual care) costs and quality-adjusted life years (QALYs) derived from SF-36 data. The mean incremental cost-effectiveness ratio in the main analysis was US dollars 15463 per QALY. The mean incremental cost-effectiveness ratios for the sensitivity analyses ranged from US dollars 11341 (using geographic block variables to control for pre-intervention service utilization) to US dollars 19976 (increasing the cost estimates by 50%) per QALY. CONCLUSIONS: This quality improvement depression intervention was cost-effective relative to usual care compared to cost-effectiveness ratios for common primary care interventions and commonly cited cost-effectiveness ratio thresholds for intervention implementation.
BT - Journal of general internal medicine
C5 - Financing & Sustainability
CP - 6
CY - United States
IS - 6
JF - Journal of general internal medicine
N2 - OBJECTIVE: To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN: Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. SETTING: Primary care practices located in 10 states across the United States. PATIENTS/PARTICIPANTS: Two hundred eleven patients beginning a new treatment episode for major depression. INTERVENTIONS: Training the primary care team to assess, educate, and monitor depressed patients during the acute and continuation stages of their depression treatment episode over 1 year. MEASUREMENTS AND MAIN RESULTS: Cost-effectiveness was measured by calculating incremental (enhanced minus usual care) costs and quality-adjusted life years (QALYs) derived from SF-36 data. The mean incremental cost-effectiveness ratio in the main analysis was US dollars 15463 per QALY. The mean incremental cost-effectiveness ratios for the sensitivity analyses ranged from US dollars 11341 (using geographic block variables to control for pre-intervention service utilization) to US dollars 19976 (increasing the cost estimates by 50%) per QALY. CONCLUSIONS: This quality improvement depression intervention was cost-effective relative to usual care compared to cost-effectiveness ratios for common primary care interventions and commonly cited cost-effectiveness ratio thresholds for intervention implementation.
PP - United States
PY - 2003
SN - 0884-8734; 0884-8734
SP - 432
EP - 441
EP - 
T1 - Cost-effectiveness of a primary care depression intervention
T2 - Journal of general internal medicine
TI - Cost-effectiveness of a primary care depression intervention
U1 - Financing & Sustainability
U2 - 12823650
VL - 18
VO - 0884-8734; 0884-8734
Y1 - 2003
ER -