Organizational factors and depression management in community-based primary care settings

Post, Edward P; Kilbourne, Amy M; Bremer, Robert W; Solano, Francis X; Pincus, Harold Alan; Reynolds, Charles F

doi:10.1186/1748-5908-4-84

Implementation Science

Table 1 Depression care organizational survey elements.

From: Organizational factors and depression management in community-based primary care settings

Framework domain	Key variables^a	Responses	Reference^b
Organizational structure
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
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)	1990 [57]; Shortell 1991 [43]
	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
	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]

^aVariables are included if they are: important (to primary care organization or patient care), measurable, and mutable (able to be modified at the primary care office level).
^bIncludes references for measures that have been applied to primary care settings directly or can potentially be derived for use in primary care settings.

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ISSN: 1748-5908

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