Rachel Mosher Henke
Dissertation Title: "Quality Improvement for Depression: Organizational and Provider Factors"
Improving the quality of depression treatment in the primary care setting is an important yet elusive goal. Few individuals with depression receive adequate treatment in this setting even though multiple efficacious treatments exist. National public awareness campaigns and educational efforts have focused on improving the quality of depression care but there is little indication that these efforts have had an effect. The aim of this dissertation is to explore the reason behind the limited success of these efforts. The first essay explores how organizational factors and clinician characteristics affect the provision of depression care. The second essay examines patterns and correlates of depression treatment adjustment, as increasing the intensity of care for patients who have not improved is known to improve outcomes. The third essay investigates the physicians’ perspective on barriers to depression treatment. All three essays provide insight on promising ways to approach quality improvement goals in future efforts.