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Characterizing Primary Care For Patients With Major Depressive Disorder Using Electronic Health Records Of A Us-Based Healthcare Provider, Sharon L. Larson, Andrei Nemoianu, Debra F Lawrence, Melissa A Troup, Michael R Gionfriddo, Bobak Pousti, Haiyan Sun, Faisal Riaz, Eric S Wagner, Lambros Chrones, Maelys Touya
Characterizing Primary Care For Patients With Major Depressive Disorder Using Electronic Health Records Of A Us-Based Healthcare Provider, Sharon L. Larson, Andrei Nemoianu, Debra F Lawrence, Melissa A Troup, Michael R Gionfriddo, Bobak Pousti, Haiyan Sun, Faisal Riaz, Eric S Wagner, Lambros Chrones, Maelys Touya
College of Population Health Faculty Papers
Background: Major depressive disorder (MDD) is predominantly managed in primary care. However, primary care providers (PCPs) may not consistently follow evidence-based treatment algorithms, leading to variable patient management that can impact outcomes.
Methods: We retrospectively analyzed adult patients with MDD seen at Geisinger, an integrated health system. Utilizing electronic health record (EHR) data, we classified patients as having MDD based on International Classification of Disease (ICD)-9/10 codes or a Patient Health Questionnaire (PHQ)-9 score ≥5. Outcomes assessed included time to first visit with a PCP or behavioral health specialist following diagnosis, antidepressant medication switching, persistence, healthcare resource utilization (HRU), and …
Medicaid Spending Burden Among Beneficiaries With Treatment-Resistant Depression., Dominic Pilon, John J. Sheehan, Holly Szukis, David Singer, Philippe Jacques, Dominique Lejeune, Patrick Lefebvre, Paul E. Greenberg
Medicaid Spending Burden Among Beneficiaries With Treatment-Resistant Depression., Dominic Pilon, John J. Sheehan, Holly Szukis, David Singer, Philippe Jacques, Dominique Lejeune, Patrick Lefebvre, Paul E. Greenberg
College of Population Health Faculty Papers
AIM: To evaluate Medicaid spending and healthcare resource utilization (HRU) in treatment-resistant depression (TRD).
MATERIALS & METHODS: TRD beneficiaries were identified from Medicaid claims databases (January 2010-March 2017) and matched 1:1 with major depressive disorder (MDD) beneficiaries without TRD (non-TRD-MDD) and randomly selected patients without MDD (non-MDD). Differences in HRU and per-patient-per-year costs were reported in incidence rate ratios (IRRs) and cost differences (CDs), respectively.
RESULTS: TRD beneficiaries had higher HRU than 1:1 matched non-TRD-MDD (e.g., inpatient visits: IRR = 1.41) and non-MDD beneficiaries (N = 14,710 per cohort; e.g., inpatient visits: IRR = 3.42, p < 0.01). TRD beneficiaries incurred greater costs versus non-TRD-MDD (CD = US$4382) and non-MDD beneficiaries (CD = US$8294; p < 0.05).
CONCLUSION: TRD is associated …