MN Community Measurement's quality measure promises improved depression care

Efforts to improve depression care in Minnesota and surrounding areas will benefit from a first-of-its-kind quality measure introduced this week by MN Community Measurement, a nonprofit organization that provides objective information on the quality of health care through its Web site.

The measure reports the percentage of patients at participating clinics who were documented as being in remission - or no longer depressed - six months after being diagnosed using a standard questionnaire called the PHQ-9. The data include 13,600 patients with diagnosed depression at 54 participating primary care and behavioral health clinics, mostly in the Twin Cities metro area. The remission rate for all patients was 4%. The top-performing clinic had a remission rate of 11% for its patients.

"Withdrawal and lack of initiative are major symptoms of depression. Over time, patients will often miss appointments, discontinue their medications or otherwise disengage from care," said Jim Chase, president of MN Community Measurement. "Initial remission rates for our quality measure are low. We believe this is due in part to the fact that many of the patients did not have regular contact with their providers and did not have a follow-up PHQ-9 test. This new measure helps providers understand how well they are staying engaged with their patients with depression. The PHQ-9 enables us to look at the outcomes of depression care and give providers the information they need to improve depression diagnosis, monitoring and treatment."

Unique and useful measure

The new measure promises to be the most useful barometer of depression care quality in Minnesota because it is the only measure that will report outcomes for all patients with diagnosed depression, without regard to care setting, treatment approach or ability of the provider to maintain contact with the patient. No other state has undertaken a similar project.

The data reported this week will be the baseline for tracking the effects of large- and small-scale improvement efforts. Chase expects the number of patients represented in the depression care data to grow rapidly, as many more clinics statewide have indicated they are adopting the PHQ-9 survey and making other preparations to submit data for the second reporting cycle in 2010.

"Minnesotans should be proud of the commitment of our health care community to measure and improve the quality of care," said Chase. "For example, the percentage of patients statewide who have optimal control of their diabetes has improved from 4% to 19% in the five years since we began collecting and reporting diabetes data. We hope in five years time to look back at these depression results and say it was the beginning of a dramatic improvement in health and quality of life for thousands of Minnesotans who suffer needlessly from depression."

www.mnhealthscores.org