Depression management within GP-centered health care - A case-control study based on claims data

Freytag, Antje; Krause, Markus; Lehmann, Thomas; Schulz, Sven; Wolf, Florian; Biermann, Janine; Wasem, Jürgen und Gensichen, Jochen (2017): Depression management within GP-centered health care - A case-control study based on claims data. In: General Hospital Psychiatry, Bd. 45: S. 91-98

Abstract

Objective: For most patients with depression, GPs are the first and long-term medical providers. GP-centered health care (GPc-HC) programs target patients with chronic diseases. What are the effects of GPc-HC on primary care depression management? Method: An observational retrospective case-control study was conducted using health insurance claims data of patients with depressive disorder from July 2011 to December 2012. Results: From40,298 patients insured with the largest health plan in Central Germany participating in the GPc-HC program (intervention group, IG), we observed 4645 patients with depression over 18 months: 72.2% women;66.6 years (mean);multiple conditions (morbidity-weight 2.50 (mean), 86% > 1.0). We compared them with 4013 patients who did not participate (control group). In participants we found lower number of incomplete/non-specified depression diagnoses (4.46vs.4.82;MD-0.36;p < 0.01);lower rate of patients consulting more than one GP-practice (49.1% vs. 58.0%;PP-8.9;p < 0.01);more GP-contacts (18.19vs. 15.59;MD + 2.60;p < 0.01);more GP-initiated referrals to specialists (82.9% vs. 79.3%;PP + 3.6;p < 0.05), more antidepressant pharmacotherapy prescribed by a GP (37.9% vs. 35.4%;PP+ 2.5;p < 0.05), more frequent guideline-concordant therapy duration (19.2% vs. 13.1%;PP + 6.1;p < 0.01) and more patients receiving " GP-psychosomatic basic care" (38.2% vs. 30.2%;PP + 8.0;p < 0.01). Conclusion: Depressive patients participating in a GPc-HC programmay be more often diagnosed by a GP, receive symptom-monitoring and appropriate depression treatment.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 0163-8343
• Sprache: Englisch