When depression is the diagnosis, what happens to patients and are they satisfied?
OBJECTIVE
To understand the process, outcomes, and patient satisfaction of usual primary care for patients given a diagnostic code for depression.


METHODS
Health plan data were used to identify patients with a diagnostic code for depression (and no such diagnosis in the preceding 6 months). Patients were surveyed by mail soon after the coded visit and again 3 months later about the care they had received; their charts were also audited.


METHODS
The 274 patients in 9 primary care clinics who responded to both surveys reported on their personal characteristics, depression symptoms and history, the care received in that initial visit, and the follow-up care during the next 3 months. They also reported on their satisfaction with various aspects of that care.


RESULTS
These patients were likely to be given antidepressant medications as their main or only treatment. Referral for mental health therapies was not used often, even though referral is readily available in this setting; other types of self-management recommendations and support were even less frequent. Patient outcomes and levels of satisfaction during a 3-month follow-up period were unimpressive.


CONCLUSIONS
To successfully maintain a key role in the care of this important problem for their patients, primary care physicians may need to incorporate a more comprehensive and systematic approach to management that involves other team members and is more satisfying to patients.
Solberg
Leif I
LI
HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA. leif.i.solberg@healthpartners.com
Fischer
Lucy Rose
LR
Rush
William A
WA
Wei
Feifei
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D006123:Group Practice / Q000592:standards; D019538:Health Care Surveys; D006801:Humans; D038801:International Classification of Diseases; D008485:Medical Audit; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
D000928:Antidepressive Agents