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This study conducted a survey of 410 primary care providers' depression-related practices to compare the knowledge and attitudes of staff or group-model managed care organizations (MCOs) with those of network-model MCOs. Knowledge was measured based on depression guidelines and attitudes (beliefs about burden, skill, and barriers) related to depression and reported behavior. Both types of MCO providers are equally knowledgeable about treating depression, and perceive equivalent skills in treating depression. However, staff/group-model providers have stronger beliefs that treating depression is burdensome to their practice, whereas network model providers report limited access to mental health specialty referral as a barrier. Accordingly, although the staff/group-model MCOs had greater access to referrals, network-model organizations are more likely to treat depression themselves. Improving primary care for depression will require unique strategies beyond enhancing technical knowledge for the two types of MCOs.

Originally published in: Journal of General Internal Medicine, v. 14, no. 1, 1999, pp. 39-48.

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