From: Organizational factors and depression management in community-based primary care settings
Framework domain | Key variablesa | Responses | Referenceb |
---|---|---|---|
Organizational structure | Â | Â | Â |
   Resources |  |  |  |
Staffing | Staffing volume and mix | Total # of staff; Ratio of (NP+PA) to MDs | Yano 2000 [9] |
Finances | Financial stress | Worry about finances a little or a lot; No worry | Meredith 1999 [31] |
Turnover | Proportion of staff who were not working in office 2 years ago | % | Rost 2001 [55] |
   Quality improvement capability | Office ever implemented a quality improvement program for a chronic condition | Yes; No; Don't know | Casalino 2003 [32] |
 | Clinical reminders for depression care | Yes; No; Don't know | Casalino 2003 [32] |
 | Formal screening method for depression | Yes; No; Don't know | Casalino 2003 [32] |
   Information technology infrastructure | Use of electronic medical record | Yes; No | Casalino 2003 [32] |
 | Registry for depressed patients | Yes; No | Casalino 2003 [32] |
   Performance incentives | Types of financial and non-financial incentives used in general and for depression care | Quality or Productivity bonus; Compensation at risk; Publicizing performance; Insurance | Casalino 2003 [32] |
Organizational process | Â | Â | Â |
   Staff performance | How often do providers in office regularly meet | Weekly; Biweekly; Monthly; | Rost 2001 [55] |
 |  | Quarterly; No regular meetings |  |
   Mental health integration |  |  |  |
Coordination | Access to mental health specialist | Yes: < 4 blocks; Yes: > 4 blocks; No | Yano 2000 [9] |
 | Primary locus of depression care for patients without comorbidities; with substance use disorder; with psychiatric comorbidities; and with major medical comorbidities |  | Yano 2000 [9] |
 | Diagnostic, CPT codes used for depression diagnosis and treatment | Depression-related; Non-depression related; Total time | Rost 1994 [56] |
 | Difficulty in arranging an appointment for patients with a mental health specialist (MHS) | Never; Rarely; Sometimes; Often; Always | Yano 2000 [9] |
Communication | Typical mode of communication | No communication; | Morrissey and Burns |
 |  | Yes (e.g., by telephone, letter, referral form) | |
 | How often PCP communicates with MHS | Never; Rarely; Sometimes; Often; Always | Miles 2003 [58] |
 | Does PCP hear whether patient made MH appt | Yes; No | Miles 2003 [58] |
Comprehensiveness | Presence of psychologist, psychiatrist, psychiatric social worker, psychiatric nurse, or other mental health specialist in office | Any MHS; None | Yano 2000 [9] |
 | Case management for depression | Yes; No | Yano 2000 [9] |
Information technology performance | Information technology implementation scale | Summary score | Doebbeling 2004 [52] |
Contextual factors | Â | Â | Â |
 | Practice size | # Offices in practice | Casalino 2003 [32] |
 | Office location (urban, non-urban) | Urban: in Pittsburgh; Suburban: outside Pittsburgh | Yano 2000 [9] |
 | Academic affiliation (i.e., office involved in resident or medical school teaching) | Yes; No | Yano 2000 [9] |