Table 2.
Demographics and Outcomes for Collaborative Care for the Kaiser Permanente Southern California (KPSC) Depression Care Management (DCM) Initiative Across Time
| 2015 | 2016 | 2017 | 2018 | |
|---|---|---|---|---|
| Patients newly diagnosed with depression (NDD) in adult primary care (APC) | 45,535 | 56,641 | 63,843 | 71,257 |
| Patients NDD in APC with PHQ-9, %(n) | 10.7 (4871) | 18.0 (10,221) | 37.1 (23,691) | 50.9 (36,307) |
| Referrals to psychiatry for patients NDD, % (n) | 5.7 (2598) | 5.5 (3100) | 6.4 (4077) | 7.5 (5323) |
| Patients NDD in APC with PHQ-9 total score 10–19 (eligible for DCM program) | 2650 | 5195 | 11,373 | 16,304 |
| Patients enrolled in the DCM program (n) | 3270 | 3751 | 4826 | 5205 |
| Women, % (n) | 73 (2376) | 72 (2711) | 76 (3642) | 76 (3979) |
| Race/ethnicity, % (n) | ||||
| Hispanic | 51 (1660) | 45 (1702) | 44 (2108) | 47 (2427) |
| White | 33 (1071) | 36 (1349) | 36 (1756) | 34 (1766) |
| Black | 9 (278) | 10 (388) | 11 (533) | 10 (539) |
| Asian | 5 (174) | 5 (187) | 5 (255) | 4 (217) |
| Other | 3 (87) | 3 (125) | 4 (174) | 5 (256) |
| Language spoken, % (n) | ||||
| English | 79 (2591) | 81 (3033) | 85 (4110) | 84 (4375) |
| Spanish | 20 (655) | 18% (686) | 14 (686) | 15 (810) |
| Other | 1 (24) | 1 (32) | 1 (30) | 1 (20) |
| Age (years) | 56.3 ± 16.8 | 54.8 ± 17.5 | 53.6 ± 17.8 | 51.1 ± 18.3 |
| 18–29, % (n) | 7 (243) | 10 (390) | 12 (568) | 16 (819) |
| 30–64, % (n) | 58 (1907) | 59 (2213) | 58 (2810) | 57 (2985) |
| 65+, % (n) | 34 (1120) | 31 (1148) | 30 (1448) | 27 (1401) |
| PHQ-9 total score at enrollment | 12 ± 6 | 12 ± 5 | 13 ± 5 | 13 ± 4 |
| PHQ-9 < 5, % (n) | 14 (458) | 7 (275) | 3 (127) | 3 (141) |
| PHQ-9 5–9, % (n) | 8 (249) | 18 (682) | 19 (896) | 13 (697) |
| PHQ-9 10–19, % (n) | 71 (2307) | 67 (2526) | 71 (3434) | 78 (4064) |
| PHQ-9 20+, % (n) | 8 (256) | 7 (268) | 8 (369) | 6 (303) |
| Months of treatment for discharged patients | 5.1 ± 6.7 [n = 3213] | 5.6 ± 6.9 [n = 3741] | 5.3 ± 4.2 [n = 4787] | 4.6 ± 3.0 [n = 4920] |
| < 1, % (n) | 21 (668) | 15 (578) | 6 (269) | 6 (272) |
| 1–3, % (n) | 36 (1153) | 33 (1222) | 29 (1370) | 30 (1455) |
| 3–6, % (n) | 17 (547) | 23 (868) | 33 (1570) | 38 (1878) |
| 6–12, % (n) | 15 (466) | 16 (600) | 25 (1190) | 24 (1189) |
| 12+, % (n) | 12 (379) | 13 (473) | 8 (388) | 3 (126) |
| Patients taking antidepressants during the DCM program, % (n) | 56.0 (1830) | 59.2 (2221) | 60.4 (2913) | 59.6 (3103) |
| Patients engaged while in the DCM program*, % (n) | 41.8 (1370) | 54.4 (2040) | 69.0 (3333) | 73.7 (3837) |
| Depression symptom improvement† at discharge from DCM program, % (n) | 54 (592) [n = 1101] | 55 (848) [n = 1548] | 56 (1397) [n = 2490] | 62 (1678) [n = 2727] |
| Depression symptom remission‡ at discharge from the DCM program, % (n) | 37 (411) [n = 1101] | 38 (596) [n = 1548] | 41 (1033) [n = 2490] | 45 (1235) [n = 2727] |
| Depression symptom improvement† at 6 months after discharge from the DCM program, % (n) | 70 (138) [n = 197] | 59 (297) [n = 505] | 61 (777) [n = 1276] | 61 (693) [n = 1132] |
| Depression symptom remission‡ at 6 months after discharge from the DCM program, % (n) | 56 (110) [n = 197] | 43 (218) [n = 505] | 48 (615) [n = 1276] | 47 (536) [n = 1132] |
*Engagement in treatment was defined as patients who had at least two PHQ-9 assessments following the enrollment PHQ-9 for at least 3 months of treatment (at least three PHQ-9 measures in total)
†Depression symptom improvement was defined as having at least a 50% reduction in the PHQ-9 total score at discharge compared with the enrollment total score. Only patients with a PHQ-9 total score of 10+ who were discharged after at least 3 months of treatment were considered for improvement outcomes
‡Depression symptom remission was defined as having a PHQ-9 total score at discharge < 5. Only patients with a PHQ-9 total score of 10+ who were discharged after at least 3 months of treatment were considered for improvement outcomes