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Impact of Collaborative Care for Depression on Clinical, Functional, and Work Outcomes: A Practice-Based Evaluation

Shippee, Nathan D. PhD; Shah, Nilay D. PhD; Angstman, Kurt B. MD; DeJesus, Ramona S. MD; Wilkinson, John M. MD; Bruce, Steven M. MD; Williams, Mark D. MD

Journal of Ambulatory Care Management: January/March 2013 - Volume 36 - Issue 1 - p 13–23
doi: 10.1097/JAC.0b013e318276dc10
Original Articles
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Background: The impact of collaborative care (CC) on depression and work productivity in routine, nonresearch primary care settings remains unclear due to limited evidence.

Methods: This prospective study examined depression and work outcomes (eg, absenteeism, presenteeism) for 165 individuals in CC for depression versus 211 patients in practice as usual in a multisite primary care practice.

Results: CC predicted greater adjusted 6-month improvements in treatment response, remission, and absenteeism versus practice as usual. Response/remission increased productivity overall.

Conclusions: CC increased clinical and work improvements in a nonresearch care setting. Insurers and employers should consider CC's work benefits in developing payment structures.

Division of Health Policy and Management, University of Minnesota, Minneapolis (Dr Shippee); and Division of Health Care Policy and Research (Dr Shah), Department of Family Medicine (Drs Angstman, Wilkinson, and Bruce), Primary Care Internal Medicine (Dr DeJesus), and Department of Psychiatry and Psychology (Dr Williams) Mayo Clinic, Rochester, Minnesota.

Correspondence: Nathan D. Shippee, PhD, Division of Health Policy and Management, University of Minnesota, D375 Mayo MMC729, 420 Delaware St SE, Minneapolis, MN 55455 (nshippee@umn.edu).

Funding for this study came from the involved practices of Primary Care Internal Medicine, Family Medicine, and Psychiatry, Mayo Clinic, and from the Mayo Foundation for Medical Education and Research.

The authors report no conflicts of interest.

The authors acknowledge the assistance of Anna Johnson, James Naessens, Isaac Johnson, and Roxanne Brennan.

© 2013 Lippincott Williams & Wilkins, Inc.