title: Costs and quality in the treatment of acute depression in primary care: a comparison between England, Germany and Switzerland.
abstract: No study has yet compared the costs and quality of depression treatment between European countries. The present study aimed to compare the costs and quality of treatment for the first manifestation of an acute major depression in England, Germany and Switzerland. Seventy-four randomly selected physician practices assessed their services for one hypothetical average patient (cost evaluation) and 73 practices reported retrospective data on one real patient (quality evaluation) for the year 2001. Reimbursement fees served as unit costs for Germany and Switzerland. Average reimbursement fees were used to measure resource utilization in all countries. Resource utilization was lowest in Switzerland. The percentage of patients receiving evidence-based treatment for major depression was insignificantly higher in Switzerland and England compared to Germany (56%, 52% and 35%, respectively; P>0.30). Switzerland was both the most effective and the most efficient country (in terms of resource utilization) in providing outpatient treatment for depression.
authors.affiliation: Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universität zu Köln, Köln , Germany. afschin.gandjour@medizin.uni-koeln.de
authors.forename: Afschin
authors.initials: A
authors.lastname: Gandjour
authors.forename: Axel
authors.initials: A
authors.lastname: Telzerow
authors.forename: Karl W
authors.initials: KW
authors.lastname: Lauterbach
mesh_terms: D000208:Acute Disease; D000928:Antidepressive Agents / Q000627:therapeutic use; D003625:Data Collection; D003865:Major Depressive Disorder / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D004739:England; D005858:Germany; D019983:Guideline Adherence; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data; D011613:Psychotherapy; D011785:Quality Assurance, Health Care / Q000191:economics*; D012189:Retrospective Studies; D013557:Switzerland
chemical_list: D000928:Antidepressive Agents