Solberg Leif I, Fischer Lucy Rose, Rush William A, Wei Feifei
HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA.
Am J Manag Care. 2003 Feb;9(2):131-40.
To understand the process, outcomes, and patient satisfaction of usual primary care for patients given a diagnostic code for depression.
Health plan data were used to identify patients with a diagnostic code for depression (and no such diagnosis in the preceding 6 months). Patients were surveyed by mail soon after the coded visit and again 3 months later about the care they had received; their charts were also audited.
The 274 patients in 9 primary care clinics who responded to both surveys reported on their personal characteristics, depression symptoms and history, the care received in that initial visit, and the follow-up care during the next 3 months. They also reported on their satisfaction with various aspects of that care.
These patients were likely to be given antidepressant medications as their main or only treatment. Referral for mental health therapies was not used often, even though referral is readily available in this setting; other types of self-management recommendations and support were even less frequent. Patient outcomes and levels of satisfaction during a 3-month follow-up period were unimpressive.
To successfully maintain a key role in the care of this important problem for their patients, primary care physicians may need to incorporate a more comprehensive and systematic approach to management that involves other team members and is more satisfying to patients.
了解为诊断为抑郁症的患者提供常规初级护理的过程、结果及患者满意度。
利用健康计划数据识别出诊断为抑郁症的患者（且在之前6个月内无此类诊断）。在编码就诊后不久通过邮件对患者进行调查，3个月后再次调查他们所接受的护理情况；同时对他们的病历进行审核。
9家初级护理诊所中对两项调查均做出回应的274名患者报告了他们的个人特征、抑郁症状及病史、首次就诊时接受的护理以及接下来3个月的后续护理情况。他们还报告了对该护理各方面的满意度。
这些患者很可能接受抗抑郁药物作为主要或唯一治疗。心理健康治疗转诊并不常用，尽管在此环境下很容易获得转诊；其他类型的自我管理建议和支持甚至更少。3个月随访期内患者的治疗结果和满意度并不理想。
为在照料患者这一重要问题上成功发挥关键作用，初级护理医生可能需要采用一种更全面、系统的管理方法，该方法要涉及其他团队成员且能让患者更满意。
