National Rates and Patterns of Depression Screening in Primary Care: Results From 2012 and 2013
National Rates and Patterns of Depression Screening in Primary Care: Results From 2012 and 2013
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DOI：
10.1176/appi.ps.201600096
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发表时间：
2017-07-01
影响因子：
3.8
通讯作者：
Matthews, Elizabeth B.
中科院分区：
文献类型：
--
作者：
Akincigil, Ayse;Matthews, Elizabeth B.
目的：尽管在初级保健中抑郁症的患病率很高，但抑郁症状往往未被医生发现。抑郁症筛查现在被推荐为常规初级保健的一部分，然而，最近的估计率和抑郁症筛查模式缺乏文献。本研究探讨了国家率和模式的抑郁症筛查之间的访问办公室为基础的初级保健physics.Methods：从2012年和2013年全国门诊医疗调查的数据进行了二次分析。结果：抑郁症筛查的总检出率为4.2%。非裔美国人接受筛查的可能性是白人的一半，老年患者接受筛查的可能性是中年患者的一半。患有慢性病的患者比没有慢性病的患者更有可能接受抑郁症筛查，并且随着每一个额外的慢性病而增加。与使用纸质图表的提供者相比，完全采用电子健康记录（EHR）的提供者更有可能筛查抑郁症。筛查率与供应商参与联邦计划的意图无关，该计划为有意义地使用经认证的EHRs.Conclusions：抑郁症筛查的总体比率较低。目前的筛查做法可能会加剧抑郁症护理中现有的差距。EHR系统可能是提高筛查率的有效工具。
Objectives: Despite high prevalence rates of depression in primary care, depressive symptoms are often undetected by physicians. Screening for depression is now recommended as a part of routine primary care; however, recent estimates of rates and patterns of depression screening are lacking in the literature. This study examined national rates and patterns of depression screening among visits to office-based primary care physicians.Methods: A secondary analysis of data from the 2012 and 2013 National Ambulatory Medical Care Survey was conducted. The sample consisted of 33,653 physician-patient encounters.Results: The overall rate of depression screening was 4.2%. African Americans were half as likely to be screened compared with whites, and elderly patients were half as likely to be screened compared with middle-aged patients. Patients with a chronic condition were more likely than patients without a chronic condition to receive depression screening, and the likelihood of being screened increased with each additional chronic condition. Providers who had fully adopted electronic health records (EHRs) were more likely to screen for depression compared with providers who used paper charts. Screening rates were not associated with providers' intentions to participate in the federal program that provides financial incentives for the meaningful use of certified EHRs.Conclusions: Overall rates of depression screening were low. Current screening practices may exacerbate existing disparities in depression care. EHR systems may be an effective tool to improve screening rates.