The Quality of Care for Depressive and Anxiety Disorders in the United States

作者：Alexander S. Young, Ruth Klap, C D Sherbourne, Kenneth B. Wells · 发表于：Archives of General Psychiatry · 年份：2001 · DOI：10.1001/archpsyc.58.1.55 · 被引用次数：1083 · 研究领域：Mental Health Treatment and Access、Treatment of Major Depression、Primary Care and Health Outcomes

BACKGROUND: Depressive and anxiety disorders are prevalent and cause substantial morbidity. While effective treatments exist, little is known about the quality of care for these disorders nationally. We estimated the rate of appropriate treatment among the US population with these disorders, and the effect of insurance, provider type, and individual characteristics on receipt of appropriate care. METHODS: Data are from a cross-sectional telephone survey conducted during 1997 and 1998 with a national sample. Respondents consisted of 1636 adults with a probable 12-month depressive or anxiety disorder as determined by brief diagnostic interview. Appropriate treatment was defined as present if the respondent had used medication or counseling that was consistent with treatment guidelines. RESULTS: During a 1-year period, 83% of adults with a probable depressive or anxiety disorder saw a health care provider (95% confidence interval [CI], 81%-85%) and 30% received some appropriate treatment (95% CI, 28%-33%). Most visited primary care providers only. Appropriate care was received by 19% in this group (95% CI, 16%-23%) and by 90% of individuals visiting mental health specialists (95% CI, 85%-94%). Appropriate treatment was less likely for men and those who were black, less educated, or younger than 30 or older than 59 years (range, 19-97 years). Insurance and income had no effect on receipt of appropriate care. CONCLUSIONS: It is possible to evaluate mental health care quality on a ...