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.
This report is part of the RAND Corporation Reprint series. The Reprint was a product of the RAND Corporation from 1992 to 2011 that represented previously published journal articles, book chapters, and reports with the permission of the publisher. RAND reprints were formally reviewed in accordance with the publisher's editorial policy and compliant with RAND's rigorous quality assurance standards for quality and objectivity. For select current RAND journal articles, see External Publications.
Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.