THE DETECTION AND TREATMENT OF DEPRESSION IN A LARGE HMO

这项研究探讨了内科和家庭医学的区别 执业初级保健医生对病人的发现和治疗 患有严重的抑郁症或心境恶劣。使用自我报告数据并广泛使用 接受抑郁筛查问卷量表，抑郁个体 将从一大群随机选择的样本中进行鉴定 实践健康维护组织(HMO)。这些主题将是 分配给他们的初级保健提供者，他们要么是一个家庭 执业或内科医生。 本项目的具体目的是(L)比较 家庭实践与家庭内部抑郁的发现率 内科医生，2)比较抑郁症的治疗方法 家庭医生和内科医生，3)比较健康 家庭实践与内部护理对抑郁症患者护理资源利用的影响 内科医生，以及4)比较卫生保健资源使用情况 家庭内和家庭之间检测到的抑郁症患者与未检测到的抑郁症患者 执业医师和内科医师。 使用Logistic回归分析，这些成员接受治疗的比例 通过家庭实践与内科初级保健治疗抑郁症 医生将被比较；家庭的治疗方法也将被比较 执业医生与内科医生。最后，多重线性 将使用回归来比较资源利用率 正在接受治疗的抑郁成员与没有接受治疗的成员 治疗过了。在上述所有分析中，患者的健康状况和 人口学和医生特征将作为对照 变量。

This study explores differences between Internal Medicine and Family Practice primary care physicians in detecting and treating of patients with major depression or dysthymia. Using self-report data and widely accepted depression screening questionnaire scales, depressed individuals will be identified from a randomly selected sample of a large, group practice Health Maintenance Organization (HMO). These subjects will be assigned to their primary care provider, who will either be a Family Practice or an Internal Medicine physician. The specific aims of this project are l) to compare differences in detection rates of depression between Family Practice and Internal Medicine physicians, 2) to compare treatment methods of depression between Family Practice and Internal Medicine physicians, 3) to compare health care resource use of depressed patients of Family Practice vs. Internal Medicine physicians, and 4) to compare health care resource use of detected vs. non-detected depressed patients within and between Family Practice and Internal Medicine physicians. Using logistic regression, the proportion of these members being treated for depression by Family Practice versus Internal Medicine primary care physicians will be compared; as will the treatment methods of Family Practice versus Internal Medicine physicians. Finally, multiple linear regression will be employed to compare the resource utilization of depressed members who are being treated versus those who are not being treated. In all the above analyses, patient health status and demographics, and physician characteristics will be used as control variables.