QUALITY IMPROVEMENT FOR DEPRESSION

改善抑郁症的质量

• 批准号: 6538818
• 负责人: LISA V RUBENSTEIN
• 金额: $ 24.85万
• 依托单位: RAND CORPORATION
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-01 至 2005-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6538818
• 关键词: clinical research; data collection; extended care; health care policy; health care quality; health care service evaluation; human subject; human therapy evaluation; major depression; managed care; outcomes research; psychotherapy

Policy makers do not know how to alter the structure and process of primary care to provide treatment which will improve and sustain improvement in the functional impairment associated with major depression, the fourth leading cause of disability worldwide. To address this problem, we propose the Quality Improvement for Depression (QID). The specific aims of QID are: (1) to provide integrated analyses of the long term impact of four distinct but related primary care interventions to improve depression treatment during the acute, continuation, and maintenance phase of care; and (2) to estimate the effects of high quality primary care depression treatment on long term disability. In the early stages of QID collaboration, funded investigators of four separately conceived quality improvement interventions planned and implemented a coordinated strategy for recruitment, intervention, and data collection in 108 primary care clinics in network and staff model HMOs, IPAs, PPOs, and mixed model settings. In addition to common baseline organizational and provider data, QID investigators are collecting over 80 common variables from 1,980 patients with major depression at each of three waves across the first year. This application seeks support to conduct effectiveness analyses in the combined database after standardizing patient follow-up during the second year across the four projects. This effort is needed to understand the "big picture" of how four dissemination interventions which are feasible to integrate across a variety of practice settings and populations, impact the quality and outcome of care, with sufficient power to determine whether they improve outcomes over a duration meaningful to policy makers. The analyses will inform policy debates about effective mental health treatment by providing generalizable estimates of the effect of antidepressant medication and psychotherapy on disability over the long term.

政策制定者不知道如何改变 初级保健提供可以改善和维持的治疗 改善与主要相关的功能障碍 抑郁症，全世界残疾的第四个主要原因。 到 解决这个问题，我们建议抑郁症的质量改善 （Qid）。 QID的具体目的是：（1）提供集成的 对四个不同但相关的主要主要影响的长期影响的分析 护理干预措施以改善急性治疗， 延续和保养阶段； （2）估计 长期高质量初级保健抑郁症治疗的影响 残疾。 在QID合作的早期阶段，资助 四个单独构想的质量改进的调查员 干预措施计划并实施了协调的策略 108初级保健中的招聘，干预和数据收集 网络和员工模型HMO，IPA，PPO和混合模型的诊所 设置。 除了常见的基准组织和提供商 数据，QID调查人员正在收集超过80个常见变量 1,980例在整个三波中的每一个患者 第一年。该申请寻求支持以行使有效性 标准化患者随访后，在合并数据库中进行了分析 在四个项目中的第二年。 需要这项工作 了解四个传播干预措施的“大局” 可以在各种练习环境中整合的可行 和人口，影响护理的质量和结果 确定它们是否在持续时间内改善结果的能力 对政策制定者有意义。 分析将为政策辩论提供信息 关于有效的心理健康治疗，通过提供可推广 抗抑郁药和心理治疗的影响的估计值 长期关于残疾。

项目成果

The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients.

非裔美国人、西班牙裔和白人初级保健患者对抑郁症治疗的可接受性。

• DOI: 10.1097/01.mlr.0000053228.58042.e4
• 发表时间: 2003
• 期刊: Medical care.
• 作者: Cooper,LisaA;Gonzales,JuniusJ;Gallo,JosephJ;Rost,KathrynM;Meredith,LisaS;Rubenstein,LisaV;Wang,Nae-Yuh;Ford,DanielE
• 通讯作者: Ford,DanielE