Article Text

Download PDFPDF
1 of 2 quality improvement interventions for depression in managed care was more effective but more costly than usual care

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

 QUESTION: In patients with depression, are either of 2 quality improvement (QI) interventions for improving the treatment of depression in managed care more cost effective than usual care?


Cost effectiveness analysis from a societal perspective for a cluster randomised {allocation concealed*}, unblinded,* controlled trial with 2 years of follow up.


46 primary care clinics in 6 community based managed care organisations (MCOs) in the USA.


1356 patients who were ≥ 18 years of age {mean age 44 y, 71% women}, planned to use the primary care clinic over the next 12 months, and met the Composite International Diagnostic Interview criteria for depression. Follow up at 2 years was 85%.


Matched clinics were allocated to 1 of 2 QI interventions or to usual care (ie, mailing of practice guidelines) (16 …

View Full Text


  • * See glossary.

  • Information provided by author.

  • Sources of funding: Agency for Healthcare Research and Quality; National Institute of Mental Health; John D and Catherine T MacArthur Foundation.

  • For correspondence: Dr M Schoenbaum, RAND, Arlington, VA, USA. mikels{at}