{"title":"联邦合格医疗中心协作护理模式服务的质量改进研究:统一的数据系统知情方法。","authors":"Amber Flanigan-Bodrick, Phyllis Solomon","doi":"10.1037/fsh0000955","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.</p><p><strong>Method: </strong>This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.</p><p><strong>Results: </strong>The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.</p><p><strong>Discussion: </strong>CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.2000,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach.\",\"authors\":\"Amber Flanigan-Bodrick, Phyllis Solomon\",\"doi\":\"10.1037/fsh0000955\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.</p><p><strong>Method: </strong>This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.</p><p><strong>Results: </strong>The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.</p><p><strong>Discussion: </strong>CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>\",\"PeriodicalId\":55612,\"journal\":{\"name\":\"Families Systems & Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-02-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Families Systems & Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1037/fsh0000955\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"FAMILY STUDIES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Families Systems & Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1037/fsh0000955","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"FAMILY STUDIES","Score":null,"Total":0}
引用次数: 0
摘要
协作护理模式(CoCM)是一种基于证据的方法,将行为健康纳入初级保健,以改善抑郁症的预后。本质量改进研究探讨了基于统一数据系统指标,在联邦合格的健康中心实施CoCM以改善抑郁缓解结果的有效性。统一数据系统将抑郁缓解定义为患者健康问卷-9 (PHQ-9)在首次抑郁阳性筛查后12个月±60天得分低于5分。方法:本研究使用CoCM注册表和病历数据生成2021年至2022年期间251例患者的样本。采用PHQ-9评价抑郁结局。假设检验采用多元回归和重复计量t检验。结果:样本包括近四分之三的女性和一半以上的非洲裔美国人,平均年龄为40岁。在入组和随访12个月±60天期间,CoCM与PHQ-9评分降低12.60分相关。保真度增加1分与后测PHQ-9评分降低4分相关,治疗依从性增加1分与治疗依从性降低1分相关。每增加25天的入组时间,得分下降约1/2个点。讨论:在最初的抑郁症阳性筛查后12个月±60天,忠实交付的CoCM可以支持联邦合格的健康中心提高抑郁症缓解率。忠实度、治疗依从性、入组时间和护理时间对结果有积极影响。需要进一步的研究来评估其他研究变量,包括精神药理学、精神病学和抑郁症结果的医学条件。(PsycInfo Database Record (c) 2025 APA,版权所有)。
Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach.
Introduction: The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.
Method: This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.
Results: The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.
Discussion: CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
Families Systems & HealthHEALTH CARE SCIENCES & SERVICES-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
CiteScore
1.50
自引率
7.70%
发文量
81
审稿时长
>12 weeks
期刊介绍:
Families, Systems, & Health publishes clinical research, training, and theoretical contributions in the areas of families and health, with particular focus on collaborative family healthcare.