title: Using the Electronic Medical Record to Examine Racial and Ethnic Differences in Depression Diagnosis and Treatment in a Primary Care Population.
abstract: OBJECTIVE
  We assessed racial and ethnic differences in depression diagnosis and treatment in a primary care population.
  
  
  METHODS
  A sample of primary care outpatients in 2007 was generated using the electronic medical record (EMR). Patients were considered depressed if their providers billed for depression-related codes; they were considered prescribed antidepressants if any antidepressants were on their medication list. Rates of diagnosis and medication prescription were estimated using a generalized linear model with a Poisson distribution, adjusting for covariates.
  
  
  RESULTS
  In the resulting sample (n=85,790), all minority groups were less likely to be diagnosed with depression as compared to Whites (p<0.05); 11.36% of Whites had a depression diagnosis, as compared to 6.44% of Asian Americans, 7.55% of African Americans, and 10.18% of Latino Americans. Among those with a depression diagnosis (n=11,096), 54.07% of African Americans were prescribed antidepressant medications, as compared to 63.19% Whites (p<0.05); Asian Americans and Latino Americans showed a trend of being less likely to be prescribed antidepressant medications.
  
  
  CONCLUSIONS
  Our study illustrates differences in diagnosis and treatment for minority primary care patients, and is innovative in using the EMR to probe these differences. Further research is needed to understand the underlying reasons for these observed differences.
authors: Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA.
authors: Nhi-Ha T
authors: NH
authors: Trinh
authors: Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA.
authors: Rachel
authors: R
authors: Larocca
authors: Division of Internal Medicine, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA 02114, USA.
authors: Susan
authors: S
authors: Regan
authors: Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA.
authors: Trina E
authors: TE
authors: Chang
authors: Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue Boston, MA 02115, USA ; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue Boston, MA 02115, USA ; Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street Boston MA 02114, USA.
authors: Stephen E
authors: SE
authors: Gilman
authors: Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA.
authors: Maurizio
authors: M
authors: Fava
authors: Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA ; South Cove Community Health Center, 885 Washington St Boston, MA 02111, USA.
authors: Albert
authors: A
authors: Yeung
keywords: Electronic Medical Records; Major Depressive Disorders; Minorities; Primary Care