Effect of primary care treatment of depression on service use by patients with high medical expenditures

David J Katzelnick, Kenneth A. Kobak, John H. Greist, James W. Jefferson, Henry J. Henk

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Objective: The study examined the impact of identifying and treating depression among patients who had a history of high medical expenditures. Effects on service use, disability, and quality of life were measured. Methods: A total of 786 high users of services from two primary care clinics and an equal number of randomly selected patients who were not high users were screened for depression using the Medical Outcomes Study (MOS) depression screen. High-user patients who screened positive were subsequently seen by their primary care physician for a diagnostic interview. The 20 patients with a confirmed diagnosis of depression were offered open-label antidepressant treatment by their primary care physician for six months. Results: All 20 patients completed the six-month study. Treatment resulted in significant reductions in depression and significant improvements in quality of life in the areas of social functioning, general health, mental health, physical functioning, emotional role functioning, and vitality. Days of missed work per month were reduced, and the percentage of patients who reported not being at all impaired by their depression at work increased. Costs for service use fell from $13.28 to $6.75 per day; when costs for the treatment study were added, the daily service use cost was $12.55. Conclusions: Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life. Service use decreased with treatment. A larger sample and control group are needed to determine if treatment is associated with a statistically significant decrease in medical expenditures.

Original languageEnglish (US)
Pages (from-to)59-64
Number of pages6
JournalPsychiatric Services
Volume48
Issue number1
StatePublished - Jan 1997
Externally publishedYes

Fingerprint

Health Expenditures
Primary Health Care
expenditures
Depression
quality of life
Quality of Life
Primary Care Physicians
Therapeutics
costs
physician
Costs and Cost Analysis
Health Care Costs
Antidepressive Agents
Mental Health
diagnostic
productivity
disability
mental health
Outcome Assessment (Health Care)
Interviews

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

Effect of primary care treatment of depression on service use by patients with high medical expenditures. / Katzelnick, David J; Kobak, Kenneth A.; Greist, John H.; Jefferson, James W.; Henk, Henry J.

In: Psychiatric Services, Vol. 48, No. 1, 01.1997, p. 59-64.

Research output: Contribution to journalArticle

Katzelnick, David J ; Kobak, Kenneth A. ; Greist, John H. ; Jefferson, James W. ; Henk, Henry J. / Effect of primary care treatment of depression on service use by patients with high medical expenditures. In: Psychiatric Services. 1997 ; Vol. 48, No. 1. pp. 59-64.
@article{30f367e64f8a4254a085689b83b8298e,
title = "Effect of primary care treatment of depression on service use by patients with high medical expenditures",
abstract = "Objective: The study examined the impact of identifying and treating depression among patients who had a history of high medical expenditures. Effects on service use, disability, and quality of life were measured. Methods: A total of 786 high users of services from two primary care clinics and an equal number of randomly selected patients who were not high users were screened for depression using the Medical Outcomes Study (MOS) depression screen. High-user patients who screened positive were subsequently seen by their primary care physician for a diagnostic interview. The 20 patients with a confirmed diagnosis of depression were offered open-label antidepressant treatment by their primary care physician for six months. Results: All 20 patients completed the six-month study. Treatment resulted in significant reductions in depression and significant improvements in quality of life in the areas of social functioning, general health, mental health, physical functioning, emotional role functioning, and vitality. Days of missed work per month were reduced, and the percentage of patients who reported not being at all impaired by their depression at work increased. Costs for service use fell from $13.28 to $6.75 per day; when costs for the treatment study were added, the daily service use cost was $12.55. Conclusions: Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life. Service use decreased with treatment. A larger sample and control group are needed to determine if treatment is associated with a statistically significant decrease in medical expenditures.",
author = "Katzelnick, {David J} and Kobak, {Kenneth A.} and Greist, {John H.} and Jefferson, {James W.} and Henk, {Henry J.}",
year = "1997",
month = "1",
language = "English (US)",
volume = "48",
pages = "59--64",
journal = "Psychiatric Services",
issn = "1075-2730",
publisher = "American Psychiatric Association",
number = "1",

}

TY - JOUR

T1 - Effect of primary care treatment of depression on service use by patients with high medical expenditures

AU - Katzelnick, David J

AU - Kobak, Kenneth A.

AU - Greist, John H.

AU - Jefferson, James W.

AU - Henk, Henry J.

PY - 1997/1

Y1 - 1997/1

N2 - Objective: The study examined the impact of identifying and treating depression among patients who had a history of high medical expenditures. Effects on service use, disability, and quality of life were measured. Methods: A total of 786 high users of services from two primary care clinics and an equal number of randomly selected patients who were not high users were screened for depression using the Medical Outcomes Study (MOS) depression screen. High-user patients who screened positive were subsequently seen by their primary care physician for a diagnostic interview. The 20 patients with a confirmed diagnosis of depression were offered open-label antidepressant treatment by their primary care physician for six months. Results: All 20 patients completed the six-month study. Treatment resulted in significant reductions in depression and significant improvements in quality of life in the areas of social functioning, general health, mental health, physical functioning, emotional role functioning, and vitality. Days of missed work per month were reduced, and the percentage of patients who reported not being at all impaired by their depression at work increased. Costs for service use fell from $13.28 to $6.75 per day; when costs for the treatment study were added, the daily service use cost was $12.55. Conclusions: Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life. Service use decreased with treatment. A larger sample and control group are needed to determine if treatment is associated with a statistically significant decrease in medical expenditures.

AB - Objective: The study examined the impact of identifying and treating depression among patients who had a history of high medical expenditures. Effects on service use, disability, and quality of life were measured. Methods: A total of 786 high users of services from two primary care clinics and an equal number of randomly selected patients who were not high users were screened for depression using the Medical Outcomes Study (MOS) depression screen. High-user patients who screened positive were subsequently seen by their primary care physician for a diagnostic interview. The 20 patients with a confirmed diagnosis of depression were offered open-label antidepressant treatment by their primary care physician for six months. Results: All 20 patients completed the six-month study. Treatment resulted in significant reductions in depression and significant improvements in quality of life in the areas of social functioning, general health, mental health, physical functioning, emotional role functioning, and vitality. Days of missed work per month were reduced, and the percentage of patients who reported not being at all impaired by their depression at work increased. Costs for service use fell from $13.28 to $6.75 per day; when costs for the treatment study were added, the daily service use cost was $12.55. Conclusions: Identification and treatment of depression among patients with a history of high medical expenditures improved depression and increased work productivity and quality of life. Service use decreased with treatment. A larger sample and control group are needed to determine if treatment is associated with a statistically significant decrease in medical expenditures.

UR - http://www.scopus.com/inward/record.url?scp=0031021057&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031021057&partnerID=8YFLogxK

M3 - Article

C2 - 9117501

AN - SCOPUS:0031021057

VL - 48

SP - 59

EP - 64

JO - Psychiatric Services

JF - Psychiatric Services

SN - 1075-2730

IS - 1

ER -