U.S. primary care physicians make less use of care management for depression than for asthma, congestive heart failure, or diabetes, suggesting that primary care practices are not well equipped to manage depression as a chronic illness, despite the high proportion of depression care they provide.

Care Management Processes Used Less Often for Depression Than for Other Chronic Conditions in US Primary Care Practices

Tara F. Bishop, Patricia P. Ramsay, Yuhua Bao, Lawrence P. Casalino, Harold Alan Pincus, Stephen M. Shortell

ResearchPosted on rand.org Mar 14, 2016Published in: Health Affairs, v. 35, no. 3, Mar. 2016, p. 394-400

Primary care physicians play an important role in the diagnosis and management of depression. Yet little is known about their use of care management processes for depression. Using national survey data for the period 2006-13, we assessed the use of five care management processes for depression and other chronic illnesses among primary care practices in the United States. We found significantly less use for depression than for asthma, congestive heart failure, or diabetes in 2012-13. On average, practices used fewer than one care management process for depression, and this level of use has not changed since 2006-07, regardless of practice size. In contrast, use of diabetes care management processes has increased significantly among larger practices. These findings may indicate that US primary care practices are not well equipped to manage depression as a chronic illness, despite the high proportion of depression care they provide. Policies that incentivize depression care management, including additional quality metrics, should be considered.

Key Findings

  • On average, primary care practices in the United States use less than one of five recommended care management processes for patients with depression—patient registries are the most commonly used of the five processes.
  • Primary care physicians are less likely to use care management processes for patients with depression than for patients with other chronic illnesses, such as diabetes, asthma, and congestive heart failure.
  • Large primary care practices use more care management processes—though not for depression—than small practices.
  • There was no significant increase in the use of care management processes for depression over time.

Recommendation

To better equip primary care practices to manage depression as a chronic illness, greater attention needs to be given to developing policies and incentives that will increase the use of care management processes for depression.

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Document Details

  • Copyright: Project HOPE: The People-to-People Health Foundation, Inc
  • Availability: Non-RAND
  • Year: 2016
  • Pages: 7
  • Document Number: EP-66377

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