From Collaborative Care to Population-based Management for Depression in Primary Care: Development of Clinical Databases and Applications for Quality Improvement and Research

Abstract

Abstract Background: To describe the process of developing an evolving database for Mayo Clinic primary care patients who screen positive for depression. The databases will support a broad use of these data for current and future quality improvement and research efforts. The description of their development will serve as an example for other institutions attempting to create similar data resources. Methods: The adult database (patients aged ³ 18) has data from 2007 and the adolescent database (patients aged 12 to < 18) from 2011. To be included, a patient had to be eligible for collaborative care model as a primary care patient with at least moderate symptoms of unipolar depression. The patient did not have to be enrolled in collaborative care model. The main domains of measurement are demographics, social determinants of health, mental health and substance abuse conditions, other comorbidities, interaction with collaborative care model, and questionnaire results. The data is being continuously updated as new data becomes available. Results: The adult database currently includes 117,619 unique patients with a mean age of 44.7 years, and is 66.4% female, and 88.1% non-Hispanic white. The adolescent database includes 14,684 unique patients with a mean age of 14.8 years, is 66.7% female, and 79.7% non-Hispanic white. Conclusions: These large, longitudinal, and evolving databases are a key step towards developing a learning environment to improve quality of care and conduct population-based research for patients with depression in primary care settings.