TY - JOUR
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Case Management
KW - Comorbidity
KW - Delivery of Health Care, Integrated
KW - Depression
KW - Depressive Disorder, Major/therapy
KW - Disease Management
KW - Dysthymic Disorder/therapy
KW - Female
KW - health outcomes
KW - Humans
KW - Logistic Models
KW - Male
KW - Marital Status
KW - Middle Aged
KW - primary care
KW - Primary Health Care/methods
KW - Quality Improvement
KW - Retrospective Studies
KW - Sex Factors
KW - Young Adult
AU - K. B. Angstman
AU - M. R. Meunier
AU - J. E. Rohrer
AU - S. S. Oberhelman
AU - J. A. Maxson
AU - P. A. Rahman
A1 - 
AB - BACKGROUND: The inclusion of mental health issues in the evaluation of multimorbidity generally has been as the presence or absence of the condition rather than severity, complexity, or stage. The hypothesis for this study was that clinical outcome of the depression 6 months after enrollment into collaborative care management would have a role in predicting future complexity of care tier. METHODS: This study was a retrospective chart review of 1894 primary care patients who were diagnosed with major depressive disorder or dysthymia as of December 2012. Multiple logistic regression analysis was used to test the independent associations between each variable and the odds of being included in the higher tiers (HT) group. RESULTS: Age (odds ratio [OR] = 1.022, confidence interval [CI] = 1.013-1.030, P /= 2, OR = 4.678, CI = 3.242-6.750, P /= 10) at 6 months conferred 2.280 (CI = 1.673-3.107, P < .001) times likely odds of HT level compared with clinical remission at 6 months. CONCLUSION: Patients with the diagnosis of major depression or dysthymia had greater odds of complex tier levels in the future, if depression was not treated to remission by 6 months. This study demonstrated the importance of the goal of significant improvement (ie, remission) of depression symptoms by 6 months (especially those older patients with more comorbidity) from entering into the higher complexity tiers.
BT - Journal of primary care & community health
C5 - Healthcare Disparities
CP - 1
CY - United States
DO - 10.1177/2150131913511465
IS - 1
JF - Journal of primary care & community health
N2 - BACKGROUND: The inclusion of mental health issues in the evaluation of multimorbidity generally has been as the presence or absence of the condition rather than severity, complexity, or stage. The hypothesis for this study was that clinical outcome of the depression 6 months after enrollment into collaborative care management would have a role in predicting future complexity of care tier. METHODS: This study was a retrospective chart review of 1894 primary care patients who were diagnosed with major depressive disorder or dysthymia as of December 2012. Multiple logistic regression analysis was used to test the independent associations between each variable and the odds of being included in the higher tiers (HT) group. RESULTS: Age (odds ratio [OR] = 1.022, confidence interval [CI] = 1.013-1.030, P /= 2, OR = 4.678, CI = 3.242-6.750, P /= 10) at 6 months conferred 2.280 (CI = 1.673-3.107, P < .001) times likely odds of HT level compared with clinical remission at 6 months. CONCLUSION: Patients with the diagnosis of major depression or dysthymia had greater odds of complex tier levels in the future, if depression was not treated to remission by 6 months. This study demonstrated the importance of the goal of significant improvement (ie, remission) of depression symptoms by 6 months (especially those older patients with more comorbidity) from entering into the higher complexity tiers.
PP - United States
PY - 2014
SN - 2150-1327; 2150-1319
SP - 30
EP - 35
EP - 
T1 - Future complexity of care tier affected by depression outcomes
T2 - Journal of primary care & community health
TI - Future complexity of care tier affected by depression outcomes
U1 - Healthcare Disparities
U2 - 24327598
U3 - 10.1177/2150131913511465
VL - 5
VO - 2150-1327; 2150-1319
Y1 - 2014
ER -