Five-Year Impact of Quality Improvement for Depression

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Abstract
Depressive disorders are a leading cause of disability worldwide.1-3 Yet, many depressedpatients, especially historically underserved minority groups, such as Latinosand African Americans, do not receive guideline-concordant care. Depressedprimary care patients who are Latino or African American tend to have poorerhealth outcomes, without practice interventions to improve quality, than dowhites.2,4-7 Qualityimprovement (QI) interventions for depression within primary care can improvequality of care and health outcomes over 6 to 28 months and yield cost-effectivenessratios relative to usual care (UC) that are comparable to commonly used medicaltherapies; however, not all interventions, particularly those focused onlyon providers, improve outcomes.8-15 Furthermore,interventions of longer duration may provide larger long-term benefits.16