title: Provider type and depression treatment adequacy.
abstract: We investigate the effect of initial provider (psychiatrist versus primary care physician or non-physician mental health specialist) on the adequacy of subsequent treatment for persons with depression. Our data are from MarketScan, a medical and pharmacy insurance claims database, which we use to estimate models of the likelihood of treatment for depression and the likelihood that any anti-depression treatments received are adequate. Patients initially seeing psychiatrists are most likely to receive adequate treatment. Provider type has a statistically and medically significant effect on whether any treatment occurs but a smaller effect on treatment adequacy among treated patients. Our results show the importance of provider type in treatment patterns, but the effects on patient outcomes are yet to be determined definitively.
authors.affiliation: Department of Economics and Center for Policy Research, Syracuse University, Syracuse, NY, USA. tkniesne@maxwell.syr.edu
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Kniesner
authors.forename: Regina H
authors.initials: RH
authors.lastname: Powers
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Croghan
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016208:Databases, Factual; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D036262:Empirical Research; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D015999:Multivariate Analysis; D010346:Patient Care Management / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011570:Psychiatry / Q000193:education / Q000592:standards*; D011613:Psychotherapy / Q000193:education / Q000592:standards*; D011787:Quality of Health Care; D014481:United States
chemical_list: D000928:Antidepressive Agents