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Depression and Work Productivity

Depression and Work Productivity. Rebecca Rossom, MD, MSCR HealthPartners Research Foundation. DIAMOND study. Landmark example of partnership research Parallel study designed to provide a detailed evaluation of this unique initiative 5-year NIH-funded study

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Depression and Work Productivity

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  1. Depression and Work Productivity Rebecca Rossom, MD, MSCR HealthPartners Research Foundation

  2. DIAMOND study • Landmark example of partnership research • Parallel study designed to provide a detailed evaluation of this unique initiative • 5-year NIH-funded study • Study questions developed collaboratively with DIAMOND initiative stakeholders • Goal: • to use a partnership between medical groups, health plans, and researchers to study the impact of this new collaborative care model

  3. DIAMOND Study Goals • Specific aims: • Identify effects of facilitated organizational change on • Use and sustainability of the care process • Depression symptoms, healthcare costs, productivity • Identify organizational factors that affect implementation and effects of care changes • Describe reach, adverse outcomes, adoption and implementation to evaluate potential for broader scale dissemination

  4. DIAMOND Study Goals • Compare depression care before/after • Compare patient outcomes before/after • Depression Severity • Quality of Life • Patient satisfaction • Work Productivity • Compare healthcare use/costs before/after • Measure costs/problems with implementation • Learn which practice systems are most important

  5. Previous Studies • Have proven the efficacy of the model, but in a controlled setting with research funding • Have not: • Tested the model with traditional health care funding sources • Quantified productivity gains • Described implementation costs and success factors in a non-controlled setting

  6. DIAMOND Study Design:Staggered Implementation * * * * *

  7. Before & After Study Design New Care Usual Care Measure Patient & Care System Outcomes Measure Patient & Care System Outcomes Intervention

  8. Depression & Work Productivity • 88 clinics representing 23 medical groups • Pre-implementation for DIAMOND (usual care) • Inclusion criteria: • 18+ years old • Newly started on antidepressant • Did not opt out • PHQ-9 >7 (at least mild depression) • Working at least part-time

  9. Patient Enrollment

  10. Demographic Characteristics (N=771)

  11. Depression Severity • Notes: • Major depression : PHQ-9 > 15 • Mean PHQ-9 = 12.2 (SD 4.3)

  12. Absenteeism and Presenteeism

  13. Absenteeism% Work time lost in past 7 days due to health

  14. Presenteeism% Work time impaired in past 7 days due to health

  15. Absenteeism + Presenteeism = Productivity lost

  16. Depression Severity & Productivity

  17. Summary • Even minor depression is associated with work impairment • More severe depression is associated with a greater loss of productivity • In relative terms, presenteeism due to depression may represent a more significant problem than absenteeism for employers • Other studies have shown that high-quality depression treatments are cost-effective and improve symptoms and work function; employers may find it beneficial to invest in treatment for depressed employees across the continuum of depression severity

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