||This measure aligns with the U.S. Preventive Services Task Force s (USPSTF) guidelines recommending routine screening for depression as a part of primary care for both children and adults, seeking to increase detection and treatment of depression and reduce the associated economic burden. The measure is an important contribution to the quality domain of community and population health.
The World Health Organization describes major depression as the leading cause of disability worldwide (Pratt & Brody, 2008). According to the Center for Behavioral Health Statistics and Quality (2015), in 2014, 11.7 percent of adolescents aged 12 to 17 and 6.6 percent of adults 18 years and older in the United States received a diagnosis of major depressive disorder. A study by Borner et al. (2010) found that 20 percent of adolescents are likely to have experienced depression by the time they are 18 years old. In adults, depression is the leading cause of disability in high-income countries and is associated with increased mortality due to suicide and impaired ability to manage other health-related issues (Siu, 2016).
The effects of depression in adults can include difficulties in functioning at home, in the workplace, and in social situations (Pratt & Brody, 2008). For example, 35 percent of men and 22 percent of women with depression reported that their depressive symptoms make it difficult for them to work, accomplish tasks at home, or get along with other people (Pratt & Brody, 2008). Effects of depression in adolescents are similar to those in adults; however, Siu (2016) noted depression has a negative effect on developmental trajectories in children and adolescents younger than 18 years old. Also, major depressive disorder in the adolescent population is especially problematic because it is linked with higher possibility of suicide attempt, death by suicide, and recurrence of the disorder in young adulthood.
Evidence strongly recommends screening for depression in adolescent and adult patients. Specifically, the USPSTF found convincing evidence that screening in primary care settings improves accurate identification of adolescent and adult patients with depression (Siu, 2016). Yet Borner et al. (2010) cite evidence that physicians are identifying and treating depression among adolescents even less than among adults, and that more than 70 percent of children and adolescents suffering from serious mood disorders go unrecognized or inadequately treated (Borner, 2010, p. 948). Additionally, according to the 2016 USPSTF guideline for screening for depression in children and adolescents, only 36 to 44 percent of children and adolescents with depression receive treatment, further evidence that the majority of depressed children and adolescents go untreated. Although primary care providers (PCPs) are the first line of defense in detecting depression, studies show that PCPs fail to identify up to 50 percent of depressed patients, due to both lack of time and a lack of brief, sensitive, and easy-to administer psychiatric screening tools (Borner, 2010).
Finally, according to the 2016 USPSTF guideline for screening depression among adults, the United States spent about $22.8 billion on depression treatment in 2009, and an additional estimated $23 billion on lost productivity (Siu, 2016). This substantial economic burden warrants regular screening for depression, as screening is the first step in identifying those at risk for developing major depressive disorder and closing the performance gap.
||See measure submission for more detail: http://www.qualityforum.org/ProjectTemplateDownload.aspx SubmissionID=522
Performance measure scores demonstrated an aggregate performance rate of 83%. Data reviewed for dates of service on 1/1/2012 to 3/31/2012
Aggregate measure performance rate: 5463/6583 (83.0%)
Distribution of provider scores (by NPI): N=459, Mean = 84.3%, Median=100.0%, SD=.33 Range=100
10th percentile: 0%, 25th percentile: 100.0%; 50th percentile: 100.0%; 75th percentile 100.0%
Total Claims Submitted with any G code (G8431, G8510, G8433, G8432, G8511): 10,004
Valid Denominator Criteria: 7709 (77.1% of total)
Performance Exclusion: 1126 (14.6% of valid submissions)
Total tested claims sampled and reviewed: 275 records from 77 providers
Valid denominator criteria: 275/275 (100.0% of total)
Sample Performance Exclusion (claims based): 35 (12.7% of valid)
Aggregate measure performance rate (claims based): 216/275 (78.5%)