This application's primary purpose is to provide the candidate with the means and mentorship to achieve the following goals: 1) Immediate goal: to characterize the effect of healthcare financing structure on utilization and quality of primary care services for patients with depression. 2) Long-term goals: to become an independent health services researcher, investigating policy-relevant questions about the effects of insurance structure on care for the chronically ill. The candidate will further develop and utilize research skills in health economics and psychiatric outcomes assessment; develop facility in techniques to analyze the effects of financial and organizational incentives; and acquire advanced training in quality of care measurement. He will master disease-specific skills in mental health services research by working on a multidisciplinary team studying a patient-oriented mental health intervention in a primary care setting. The career development program will incorporate formal coursework; tutorials and workshops with experts in specific methodological issues; site visits to major venues studying mental health services; and attendance and research presentations at local and national conferences. The major goal of the proposed research program is to characterize the effect of insurance structure on utilization and quality of primary care services for patients with depression. This goal will be accomplished through the planning, conduct, and analysis of a research project using data from a study that focuses on treatment for geriatric patients with depression. This study, a five-year multi-site NIMH-funded clinical intervention trial (Charles F. Reynolds, III, P.I., Prevention of Suicide in Older Primary Care: Patients [PROSPECT], is investigating strategies to improve depression treatment in primary care settings. The proposed K23 research will describe the effects of insurance structure on: individual patients' ambulatory service utilization, and the quality of care for depression. In addition, the research will assess the effect of insurance on the intervention to improve depression treatment in a primary care setting. Furthermore, this study will implement, collect, and predictably validate quality of care performance measures for several domains of depression management.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23MH001879-01A1
Application #
6330896
Study Section
Special Emphasis Panel (ZMH1-SRV-C (01))
Program Officer
Rupp, Agnes
Project Start
2001-07-01
Project End
2006-06-30
Budget Start
2001-07-01
Budget End
2002-06-30
Support Year
1
Fiscal Year
2001
Total Cost
$159,570
Indirect Cost
Name
University of Pittsburgh
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Bao, Yuhua; Alexopoulos, George S; Casalino, Lawrence P et al. (2011) Collaborative depression care management and disparities in depression treatment and outcomes. Arch Gen Psychiatry 68:627-36
Raue, Patrick J; Morales, Knashawn H; Post, Edward P et al. (2010) The wish to die and 5-year mortality in elderly primary care patients. Am J Geriatr Psychiatry 18:341-50
Bao, Yuhua; Post, Edward P; Ten, Thomas R et al. (2009) Achieving effective antidepressant pharmacotherapy in primary care: the role of depression care management in treating late-life depression. J Am Geriatr Soc 57:895-900
Bogner, Hillary R; Morales, Knashawn H; Post, Edward P et al. (2007) Diabetes, depression, and death: a randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT). Diabetes Care 30:3005-10
Gallo, Joseph J; Bogner, Hillary R; Morales, Knashawn H et al. (2007) The effect of a primary care practice-based depression intervention on mortality in older adults: a randomized trial. Ann Intern Med 146:689-98
Kilbourne, Amy M; Horvitz-Lennon, Marcela; Post, Edward P et al. (2007) Oral health in Veterans Affairs patients diagnosed with serious mental illness. J Public Health Dent 67:42-8
Kilbourne, Amy M; Rofey, Dana L; McCarthy, John F et al. (2007) Nutrition and exercise behavior among patients with bipolar disorder. Bipolar Disord 9:443-52
Kilbourne, Amy M; McCarthy, John F; Post, Edward P et al. (2007) Social support among veterans with serious mental illness. Soc Psychiatry Psychiatr Epidemiol 42:639-46
Kilbourne, Amy M; Brar, Jaspreet S; Drayer, Rebecca A et al. (2007) Cardiovascular disease and metabolic risk factors in male patients with schizophrenia, schizoaffective disorder, and bipolar disorder. Psychosomatics 48:412-7
Kilbourne, Amy M; McCarthy, John F; Post, Edward P et al. (2006) Access to and satisfaction with care comparing patients with and without serious mental illness. Int J Psychiatry Med 36:383-99

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