Impact of patient-provider communication on adequacy of depression treatment for women in the US

Background: Many women with depression are untreated or undertreated for their condition. The quality of patient-provider communication may impact the receipt of depression treatment. We examine the relationship between patient-provider communication and receipt of adequate treatment for depression among women. Methods: The sample consisted of women with depression who visited a provider in the previous 12 months in the 2002-08 Medical Expenditure Panel Survey (N=3,179). Multivariate regression was used to examine the independent contribution of sociodemographic characteristics, healthcare factors, respondent language, and patient-provider communication measures from the Consumer Assessment of Health Plan Survey on depression treatment status (none, some, adequate). Results: Over one-third of women with depression in the U.S. did not receive adequate treatment. Women reporting that providers usually or always listened carefully were more likely to receive adequate treatment (OR=1.56, 95% CI 1.07, 2.25 and OR=1.61, 95% CI 1.11, 2.34, respectively). Non-English speaking women were 50% less likely to receive adequate treatment (OR=0.49, 95% CI 0.30, 0.80). Having a usual source of care was associated with an increased likelihood of receiving some and adequate treatment (OR=1.73, 95% CI 1.16, 2.56 and OR=2.05, 95% CI 1.47, 2.85, respectively). Conclusion: Effective provider listening behaviors may help increase the number of U.S. women with depression who receive adequate treatment. Efforts to improve language access for Limited English Proficient women are likely critical for improving treatment outcomes in this population. Additionally, ensuring that depressed women have consistent access to healthcare services is important for obtaining adequate depression care.