title: Effects of staffing choices on collaborative care for depression at primary care clinics in Minnesota.
abstract: OBJECTIVE
  This study assessed associations between staffing of a collaborative care program for depression and enrollment in the program and remission rates.
  
  
  METHODS
  Data were collected from depression care registries at 63 primary care clinics that participated in the initiative through early 2012. Project leaders at the 12 medical groups that operate the clinics were surveyed about the background of care managers and clinic characteristics. Generalized linear mixed models assessed associations of care manager background and configuration of staffing with enrollment and remission rates.
  
  
  RESULTS
  Enrollment was higher (p=.050) and there was a trend toward higher remission rates (p=.105) at clinics where care managers were dedicated exclusively to depression care. No differences in outcomes were obtained by registered nurses versus certified medical assistants and licensed practical nurses.
  
  
  CONCLUSIONS
  Hiring dedicated paraprofessional care managers may maximize the cost-effectiveness of collaborative care programs and should be supported by regulations and reimbursement policies.
authors.affiliation: Ms. Pietruszewski and Ms. Hadzic are with the Institute for Clinical Systems Improvement, Bloomington, Minnesota. Dr. Mundt and Dr. Brown are with the Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison. Send correspondence to Dr. Brown (e-mail: rlbrown@wisc.edu ).
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Pietruszewski
authors.forename: Marlon P
authors.initials: MP
authors.lastname: Mundt
authors.forename: Senka
authors.initials: S
authors.lastname: Hadzic
authors.forename: Richard L
authors.initials: RL
authors.lastname: Brown
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D003865:Major Depressive Disorder / Q000628:therapy*; D019263:Dysthymic Disorder / Q000628:therapy*; D006270:Health Facility Administrators / Q000706:statistics & numerical data*; D006801:Humans; D065102:Licensed Practical Nurses / Q000706:statistics & numerical data; D008910:Minnesota; D009726:Nurses / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010560:Personnel Selection / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012074:Remission Induction