DISPARITIES IN THE PROCESS AND THE OUTCOMES OF DEPRESSION MANAGEMENT BETWEEN PEDIATRIC MAJOR DEPRESSIVE DISORDER CASES IDENTIFIED BY PRIMARY CARE PROVIDERS VERSUS PSYCHIATRISTS
Author(s)
Yucel A1, Chen H1, Essien EJ1, Aparasu R1, Mgbere O2, Bhatara V3, Alonzo J1
1University of Houston, Houston, TX, USA, 2Houston Department of Health and Human Services, Houston, TX, USA, 3University of South Dakota, Vermillion, SD, USA
OBJECTIVES: Antidepressant medication (AD) is standard treatment for moderate to severe MDD. Guidelines recommend physicians’ frequent monitoring and adherence to AD. Mental health (MH) related hospitalization is an important concern among children and adolescents. This study examined the disparities between PCP and PSY identified pediatric MDD follow-up visits, AD adherence and hospitalization. METHODS: RESULTS: Findings indicate that pediatric depression cases first identified by PSY were relatively younger 10-13 years-old (PSY:27%; PCP:20%,p=0.02)than those identified by PCPs, more likely to be male (PSY:44%, 22%, p<0.001), white (PSY:48%, PCP:37%, p=0.02) and with pre-index psychiatric comorbidities (PSY:79%, PCP:64%, p<0.001). As compared to PCP identified patients, those who were identified by PSY received more follow-up visits [Mean (SD): PSY:9.57(9.06), PCP:7.36(7.67), p=0.007]; had better medication adherence (PSY: 54%, PCP:45%, p=0.01); and less MH related hospitalization (PCP:15%, PSY: 2%, p=0.002). CONCLUSIONS: Children and adolescents identified by PSY received better quality of MDD care and experienced less hospitalization than those identified by PCPs.
Conference/Value in Health Info
2016-05, ISPOR 2016, Washington DC, USA
Value in Health, Vol. 19, No. 3 (May 2016)
Code
PMH60
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care
Topic Subcategory
Health Care Research, Health Disparities & Equity, Hospital and Clinical Practices, Quality of Care Measurement, Treatment Patterns and Guidelines
Disease
Mental Health, Pediatrics