Does Patient-Provider Gender Concordance Affect Mental Health Care Received by Primary Care Patients with Major Depression?

Published in: Women's Health Issues, v. 16, no. 3, May-June 2006, p. 122-132

Posted on RAND.org on January 01, 2006

by Kitty S. Chan, Chloe E. Bird, Robert Weiss, Naihua Duan, Lisa S. Meredith, Cathy D. Sherbourne

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PURPOSE: The authors sought to determine whether patient-provider gender concordance influences the detection and care of depression and comorbid anxiety and substance use in patients with major depression. METHODS: Cross-sectional analyses of baseline patient survey data linked with provider data were performed. Data based on routine primary care visits in clinics from a variety of health systems serving diverse patient populations across the United States. Participants all had major depression. Depression care was examined in the Quality Improvement for Depression (QID) Collaboration sample (n patients = 1,428, n providers = 389). In a subanalysis of data solely from 714 patients and 157 providers from Partners-In-Care, one of the projects participating in QID, the authors also examined detection of anxiety disorder and alcohol or drug problems. MAIN FINDINGS: Rates of detection and care of mental health problems in primary care were low even among patients with major depression. Except for anxiety counseling in female patients, patient-provider gender concordance did not improve care as hypothesized. However, female providers were more likely to counsel on anxiety and less likely to counsel on alcohol or drug use than male providers. Female patients were less likely to be counseled on alcohol or drug use compared with male patients. CONCLUSION: Detection and care of mental health and substance use problems for patients with major depression is not influenced by patient-provider gender concordance. However, depressed female patients may have greater unmet needs for alcohol and drug use counseling than their male counterparts.

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