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

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

https://doi.org/10.1136/ebm.7.3.95

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    (2001) JAMA 286, 1325. Schoenbaum M, Unützer J, Sherbourne C, et al.. Cost-effectiveness of practice-initiated quality improvement for depression. Results of a randomized controlled trial.. Sep 19;. :. –30.
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 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?

    Design

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

    Setting

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

    Patients

    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%.

    Intervention

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

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