Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109179

Carole Upshur, EdD, Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Ave. North, Worcester, MA 01655 and Jianying Zhang, MPH, Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Ave, Shrewsbury, MA 01545, 508-856-8221, jianying.zhang@umassmed.edu.

Primary care providers typically do not have systematic screening and follow up protocols in place to treat depression. They may also have difficulty obtaining behavioral health specialty care for depression patients.

Depression is highly prevalent among Massachusetts Medicaid (MassHealth) members. In order to improve depression identification and treatment for MassHealth insured adults in Massachusetts, MCDPC (The Massachusetts Consortium on Depression in Primary Care) implemented a pilot depression care management program in primary care settings.

From July 2003 to Dec 2003 the program enrolled 73 MassHealth members between the ages of 18 and 64 with depression. Preliminary results show that after 6-12 months enrollment in the program the number of psychiatric evaluation visit per member per month (PMPM) increased from 0.01 to 0.06 (p<0.0001) and the number of psychiatric office visit PMPM increased from 0.13 to 0.45 (p<0.0001). Additionally, the number of prescriptions for antidepressants PMPM increased from 0.46 to 0.78 (p<0.0001) (compared to baseline data). The results suggest that patients with depression who received care management services were more likely to receive evaluation and treatment targeted to their depression such as psychiatric visits and continuous prescriptions for antidepressants.

This study provides important evidence that depression care management in primary care settings may significantly improve identification and treatment of depression. More comprehensive analysis such as emergency room visit and acute hospital visit is underway. About another 150 more cases will be added to the analysis. A matched control group (non-care management patients with depression) will also be used to compare the care management patients with depression for their health care service utilizations.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Understand the elements of chronic disease management applied to depression care
• Identify the prevalence and correlates of depression in a primary care publicly insured population
• Describe the impact of depression care management on health care utilization

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.