title: Depression management within GP-centered health care - A case-control study based on claims data.
abstract: For most patients with depression, GPs are the first and long-term medical providers. GP-centered health care (GPc-HC) programs target patients with chronic diseases. What are the effects of GPc-HC on primary care depression management?
  
  
  
  An observational retrospective case-control study was conducted using health insurance claims data of patients with depressive disorder from July 2011 to December 2012.
  
  
  
  From 40,298 patients insured with the largest health plan in Central Germany participating in the GPc-HC program (intervention group, IG), we observed 4645 patients with depression over 18months: 72.2% women; 66.6years (mean); multiple conditions (morbidity-weight 2.50 (mean), 86%>1.0). We compared them with 4013 patients who did not participate (control group). In participants we found lower number of incomplete/non-specified depression diagnoses (4.46vs.4.82;MD-0.36; p<0.01); lower rate of patients consulting more than one GP-practice (49.1%vs.58.0%;PP-8.9;p<0.01); more GP-contacts (18.19vs.15.59;MD+2.60;p<0.01); more GP-initiated referrals to specialists (82.9%vs.79.3%;PP+3.6;p<0.05), more antidepressant pharmacotherapy prescribed by a GP (37.9%vs.35.4%;PP+2.5;p<0.05), more frequent guideline-concordant therapy duration (19.2%vs.13.1%;PP+6.1;p<0.01) and more patients receiving "GP-psychosomatic basic care" (38.2%vs.30.2%;PP+8.0;p<0.01).
  
  
  
  Depressive patients participating in a GPc-HC program may be more often diagnosed by a GP, receive symptom-monitoring and appropriate depression treatment.
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Freytag
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Krause
authors.affiliation: Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lehmann
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Schulz
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Wolf
authors.affiliation: Institute for Healthcare Management and Research, University of Duisburg-Essen, Campus Essen, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Biermann
authors.affiliation: Institute for Healthcare Management and Research, University of Duisburg-Essen, Campus Essen, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Wasem
authors.affiliation: Institute of General Practice and Family Medicine, Jena University Hospital, Germany; Institute of General Practice and Family Medicine, University Hospital of LMU Munich, Germany. Electronic address: jochen.gensichen@med.uni-muenchen.de.
authors.forename: Jochen
authors.initials: J
authors.lastname: Gensichen
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration / Q000706:statistics & numerical data*
keywords: Administrative claims, healthcare; Depression; GP-centered health care; General practitioners; Health care quality