Evidence map›Paper›PMID 36810631›Full record

ArticleJournal of general internal medicine2023

Quality of Depression Care for Veterans Affairs Primary Care Patients with Experiences of Homelessness.

Audrey L Jones, Karen Chu, Danielle E Rose, Lillian Gelberg, Stefan G Kertesz, Adam J Gordon, Kenneth B Wells, Lucinda Leung

Open access · bronzeAbstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Audrey L JonesInformatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center and Vulnerable Veteran Innovative Patient-Aligned Care Team (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, UT, 84148, USA. Audrey.Jones3@va.gov.
Karen ChuCenter for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) and Veterans Assessment and Improvement Laboratory (VAIL), VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
Danielle E RoseCenter for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) and Veterans Assessment and Improvement Laboratory (VAIL), VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
Lillian GelbergCenter for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) and Veterans Assessment and Improvement Laboratory (VAIL), VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
Stefan G KerteszBirmingham VA Health Care System, Birmingham, AL, USA.
Adam J GordonInformatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center and Vulnerable Veteran Innovative Patient-Aligned Care Team (VIP) Initiative, VA Salt Lake City Health Care System, Salt Lake City, UT, 84148, USA.
Kenneth B WellsCenter for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) and Veterans Assessment and Improvement Laboratory (VAIL), VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
Lucinda LeungCenter for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP) and Veterans Assessment and Improvement Laboratory (VAIL), VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
Center for the Study of Healthcare Provider Behavior · USVA Salt Lake City Healthcare System · USFielding Graduate University · USUniversity of Alabama at Birmingham · USUniversity of California, Los Angeles · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
Vascular Health and Risk Factors in Children with Down SyndromeKL2TR002539 · NCATS · UNIVERSITY OF UTAH · PI MURTAUGH, MAUREEN A, NYGAARD, INGRID E · 2018 to 2022
$4.3M
Primary Care Quality and Homeless Service TailoringI01HX001900 · VA · BIRMINGHAM VA MEDICAL CENTER · PI KERTESZ, STEFAN G · 2020 to 2021
–
Improving Depression Management in Primary CareIK2HX002867 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI LEUNG, LUCINDA B · 2020 to 2025
–
Quality of Mental Health Services for Homeless Veterans in Primary Care SettingsIK2HX003090 · VA · VA SALT LAKE CITY HEALTHCARE SYSTEM · PI AUDREY L JONES · 2021 to 2026
–
HSRD VA I01 HX001900HSRD VA IK2 HX002867HSRD VA IK2 HX003090NCATS NIH HHS KL2 TR002539NCATS NIH HHS UL1 TR002538
6 · The paper itself

Abstract

backgroundPersons who experience homelessness (PEH) have high rates of depression and incur challenges accessing high-quality health care. Some Veterans Affairs (VA) facilities offer homeless-tailored primary care clinics, although such tailoring is not required, within or outside VA. Whether services tailoring enhances care for depression is unstudied.

objectiveTo determine whether PEH in homeless-tailored primary care settings receive higher quality of depression care, compared to PEH in usual VA primary care.

designRetrospective cohort study of depression treatment among a regional cohort of VA primary care patients (2016-2019).

participantsPEH diagnosed or treated for a depressive disorder. MAIN MEASURES: The quality measures were timely follow-up care (3 + completed visits with a primary care or mental health specialist provider, or 3 + psychotherapy sessions) within 84 days of a positive PHQ-2 screen result, timely follow-up care within 180 days, and minimally appropriate treatment (4 + mental health visits, 3 + psychotherapy visits, 60 + days antidepressant) within 365 days. We applied multivariable mixed-effect logistic regressions to model differences in care quality for PEH in homeless-tailored versus usual primary care settings. KEY

resultsThirteen percent of PEH with depressive disorders received homeless-tailored primary care (n = 374), compared to usual VA primary care (n = 2469). Tailored clinics served more PEH who were Black, who were non-married, and who had low income, serious mental illness, and substance use disorders. Among all PEH, 48% received timely follow-up care within 84 days of depression screening, 67% within 180 days, and 83% received minimally appropriate treatment. Quality metric attainment was higher for PEH in homeless-tailored clinics, compared to PEH in usual VA primary care: follow-up within 84 days (63% versus 46%; adjusted odds ratio [AOR] = 1.61, p = .001), follow-up within 180 days (78% versus 66%; AOR = 1.51, p = .003), and minimally appropriate treatment (89% versus 82%; AOR = 1.58, p = .004).

conclusionsHomeless-tailored primary care approaches may improve depression care for PEH.

Indexed as

DepressionDepressive DisorderIll-Housed PersonsPrimary Health CareVeterans Health ServicesAdolescentAdultAgedFemaleHumansMaleMiddle AgedPatient Health QuestionnaireQuality of Health CareYoung Adultdepressionhomelessnessprimary careveterans

Identifiers

PMID36810631
PMCPMC10465405
OpenAlexW4321437450

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.