Date of Conferral

2018

Degree

Doctor of Healthcare Administration, DHA

School

Health Services

Advisor

James Rohrer

Abstract

Depression is the leading cause of disability in the United States. Insufficient evidence is available about the types of follow-up care that may be most effective. The purpose of this quantitative, retrospective cohort study was to determine whether remission of depression symptoms was associated with recommended follow-up care when controlling for age, gender, and number of previous episodes of depression, and whether symptom reduction was more likely for those who completed a course of treatment from a mental health specialist in comparison to those who were treated by their primary care providers (PCPs) when controlling for the same variables. The theoretical framework for this study was Reingold's theory of outbreak investigations. Existing was retrieved from Geisinger Health System's electronic health record. The following covariates were evaluated for their effects on the re

lationship between positive depression screening and follow-up care: baseline (initial) depression screening score, date of service, age, gender, consecutive depression screening score, date of consecutive depression screening, outcomes, and documented previous history of depression. Retrospective cohort data from 1,246 patients were collected from the study site and analyzed using descriptive statistics, t tests, ANOVAs, and multiple linear regression. Findings showed that PCP-initiated medication change and referral to community health were significantly associated with successful intervention. Findings may be used to encourage routine depression screening and increase positive health outcomes for patients with depression.

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