Clinical improvement associated with conformance to HEDIS-based depression care.
BACKGROUND
Employers recently requested a valid metric of depression treatment quality. Such an indicator needs to measure the proportion of the population in need who receive high-quality care, and to predict clinical improvement.


METHODS
We constructed an administrative database indicator derived from HEDIS criteria for antidepressant medication management, and tested it in 230 employed patients in five health plans.


RESULTS
Indicator rates were 7.0% in the population in need. Conformance to indicator criteria in this population was associated with 23.0% improvement in depression severity over 1 year (p = .02).


CONCLUSIONS
Administrative database indicators that predict clinical improvement are a very rare accomplishment. Existing depression indicators may need to be calculated for the population in need to provide a valid metric for employer purchasers.
Center for Studies in Family Medicine, Department of Family Medicine, University of Colorado Health Sciences Center, UCHSC at Fitzsimons, P.O. Box 6508 Mail Stop F496, Aurora, CO 80045-0508, USA. Kathryn.Rost@UCHSC.edu
Kathryn
K
Rost
L Miriam
LM
Dickinson
John
J
Fortney
John
J
Westfall
Richard C
RC
Hermann
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D019263:Dysthymic Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*
D000928:Antidepressive Agents