Does the Veterans Affairs Depression Performance Measure Predict Quality Care?

摘要

Depression is a common illness among veterans treated in the Department of Veterans Affairs (VA) medical centers (VAMCs). Examination of electronic medical records (EMRs) at a VA primary care clinic revealed that 5%-7% of patients had a diagnosis of depression,1 although the prevalence of depression among VA outpatients was found to be as high as 31% in a comprehensive screening program.2 Depression and related psychiatric disability continue to affect many soldiers returning from current conflicts in Iraq and Afghanistan.34 In addition to complicating the treatment of other neuropsychi-atric difficulties common among veterans, such as posttraumat-ic stress disorder and persistent postconcussive syndrome,51" depression can complicate the care of chronic medical conditions, with worse outcomes and increased costs.7 Depression is associated with low adherence to cardiac medications in patients with coronary artery disease," and higher depression severity is associated with poor diet and low adherence to oral hypoglycemic medications in patients with diabetes.9