Cost-effectiveness of a primary care depression intervention.

Abstract:

OBJECTIVE:To determine the incremental cost-effectiveness of a quality improvement depression intervention (enhanced care) in primary care settings relative to usual care. DESIGN:Following stratification, we randomized 12 primary care practices to enhanced or usual care conditions and followed patients for 12 months. SETTING:Primary care practices located in 10 states across the United States. PATIENTS/PARTICIPANTS:Two hundred eleven patients beginning a new treatment episode for major depression. INTERVENTIONS: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. MEASUREMENTS AND MAIN RESULTS: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. CONCLUSIONS: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.

journal_name

J Gen Intern Med

authors

Pyne JM,Rost KM,Zhang M,Williams DK,Smith J,Fortney J

doi

10.1046/j.1525-1497.2003.20611.x

subject

Has Abstract

pub_date

2003-06-01 00:00:00

pages

432-41

issue

6

eissn

0884-8734

issn

1525-1497

pii

jgi20611

journal_volume

18

pub_type

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