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Provider type and depression treatment adequacy.

Kniesner TJ, Powers RH, Croghan TW

Department of Economics and Center for Policy Research, Syracuse University, Syracuse, NY, USA. tkniesne@maxwell.syr.edu

We investigate the effect of initial provider (psychiatrist versus primary care physician or non-physician mental health specialist) on the adequacy of subsequent treatment for persons with depression. Our data are from MarketScan, a medical and pharmacy insurance claims database, which we use to estimate models of the likelihood of treatment for depression and the likelihood that any anti-depression treatments received are adequate. Patients initially seeing psychiatrists are most likely to receive adequate treatment. Provider type has a statistically and medically significant effect on whether any treatment occurs but a smaller effect on treatment adequacy among treated patients. Our results show the importance of provider type in treatment patterns, but the effects on patient outcomes are yet to be determined definitively.

Published 2 May 2005 in Health Policy, 72(3): 321-32.
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