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- Title
Cost-effectiveness of a primary care depression intervention.
- Authors
Pyne, Jeffrey M.; Rost, Kathryn M.; Zhang, Mingliang; Williams, D. Keith; Smith, Jeffrey; Fortney, John
- Abstract
<bold>Objective: </bold>To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care.<bold>Design: </bold>Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months.<bold>Setting: </bold>Primary care practices located in 10 states across the United States.<bold>Patients/participants: </bold>Two hundred eleven patients beginning a new treatment episode for major depression.<bold>Interventions: </bold>Training the primary care team to assess, educate, and monitor depressed patients during the acute and continuation stages of their depression treatment episode over 1 year.<bold>Measurements and Main Results: </bold>Cost-effectiveness was measured by calculating incremental (enhanced minus usual care) costs and quality-adjusted life years (QALYs) derived from SF-36 data. The mean incremental cost-effectiveness ratio in the main analysis was US dollars 15463 per QALY. The mean incremental cost-effectiveness ratios for the sensitivity analyses ranged from US dollars 11341 (using geographic block variables to control for pre-intervention service utilization) to US dollars 19976 (increasing the cost estimates by 50%) per QALY.<bold>Conclusions: </bold>This quality improvement depression intervention was cost-effective relative to usual care compared to cost-effectiveness ratios for common primary care interventions and commonly cited cost-effectiveness ratio thresholds for intervention implementation.
- Subjects
UNITED States; MENTAL depression; PRIMARY care; MEDICAL care; COST effectiveness
- Publication
JGIM: Journal of General Internal Medicine, 2003, Vol 18, Issue 6, p432
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1046/j.1525-1497.2003.20611.x