原创力文档quality of care for major depression and its determinants a multilevel analysis抑郁症的护理质量和其决定因素多层次分析.pdfVIP
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quality of care for major depression and its determinants a multilevel analysis抑郁症的护理质量和其决定因素多层次分析
Duhoux et al. BMC Psychiatry 2012, 12:142
/1471-244X/12/142
RESEARCH ARTICLE Open Access
Quality of care for major depression and its
determinants: a multilevel analysis
Arnaud Duhoux1,2,3*, Louise Fournier1,2,3, Lise Gauvin1,2 and Pasquale Roberge1,3,4
Abstract
Background: Numerous studies highlight an important gap in the quality of care for depression in primary care.
However, basic indicators were often used. Few of these studies examined factors associated with receiving
adequate treatment, particularly with a simultaneous consideration of individual and organizational characteristics.
The purpose of this study was to estimate the proportion of primary care patients with a major depressive episode
(MDE) who receive adequate treatment and to examine the individual and organizational (i.e., clinic-level)
characteristics associated with the receipt of at least one minimally adequate treatment for depression.
Methods: The sample used for this study included 915 adults consulting a general practitioner (GP), regardless of
the motive of consultation, meeting DSM-IV criteria for MDE during the 12 months preceding the survey (T1), and
nested within 65 primary care clinics. Data reported in this study were obtained from the “Dialogue” project.
Adherence rates for 27 quality indicators selected to cover the most important components of depression
treatment were estimated. Multilevel analyses were conducted.
Results: Adherence to guidelines was high (75%) for one third of the quality indicators that were measured but
was low (60%) for nearly half of the measures. Just over half of the sample (52.2%) received at least one minimally
adequate treatment for depression. At the individual level, determinants of receipt of minimally adequate care
included age, having a family physician, a supplementary insurance coverage,
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