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Research ArticleOriginal Research

Treatment Differences in Primary and Specialty Settings in Veterans with Major Depression

Victor Puac-Polanco, Lucinda B. Leung, Robert M. Bossarte, Corey Bryant, Janelle N. Keusch, Howard Liu, Hannah N. Ziobrowski, Wilfred R. Pigeon, David W. Oslin, Edward P. Post and Ronald C. Kessler
The Journal of the American Board of Family Medicine March 2021, 34 (2) 268-290; DOI: https://doi.org/10.3122/jabfm.2021.02.200475
Victor Puac-Polanco
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MD, DrPH
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Lucinda B. Leung
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MD, PhD
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Robert M. Bossarte
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
PhD
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Corey Bryant
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MS
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Janelle N. Keusch
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MPH
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Howard Liu
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
PhD
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Hannah N. Ziobrowski
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
PhD, MPH
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Wilfred R. Pigeon
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
PhD
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David W. Oslin
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MD
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Edward P. Post
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
MD, PhD
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Ronald C. Kessler
From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
PhD
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Article Information

vol. 34 no. 2 268-290
DOI 
https://doi.org/10.3122/jabfm.2021.02.200475
PubMed 
33832996

Published By 
The Journal of the American Board of Family Medicine
Print ISSN 
1557-2625
Online ISSN 
1558-7118
History 
  • Received for publication September 11, 2020
  • Revision received December 1, 2020
  • Accepted for publication December 2, 2020
  • Published online April 8, 2021.

Copyright & Usage 
© Copyright 2021 by the American Board of Family Medicine.

Author Information

  1. Victor Puac-Polanco, MD, DrPH,
  2. Lucinda B. Leung, MD, PhD,
  3. Robert M. Bossarte, PhD,
  4. Corey Bryant, MS,
  5. Janelle N. Keusch, MPH,
  6. Howard Liu, PhD,
  7. Hannah N. Ziobrowski, PhD, MPH,
  8. Wilfred R. Pigeon, PhD,
  9. David W. Oslin, MD,
  10. Edward P. Post, MD, PhD and
  11. Ronald C. Kessler, PhD
  1. From the Department of Health Care Policy, Harvard Medical School, Boston, MA (VP-P, HL, HNZ, RCK); the Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY (VP-P); the Center for the Study of Healthcare Innovation, Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles, CA (LBL); the Division of General Internal Medicine, and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA (LBL); the Department of Behavioral Medicine and Psychiatry, West Virginia University, Morgantown, (RMB); the Center of Excellence for Suicide Prevention, Canandaigua VAMC, Canandaigua, NY (RMB, HL, WRP); the VA Ann Arbor, Center for Clinical Management Research, Ann Arbor, MI (CB, JNK, EPP); the Department of Psychiatry, University of Rochester Medical Center, Rochester, NY (WRP); the Department of Medicine, University of Michigan Medical School, Ann Arbor (EPP); the Cpl Michael J Crescenz VA Medical Center, VISN 4 Mental Illness Research Education and Clinical Center, Philadelphia, PA (DWO); the Perelman School of Medicine, University of Pennsylvania, Philadelphia (DWO).
  1. Corresponding author: Ronald C. Kessler, PhD, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899 (E-mail: kessler{at}hcp.med.harvard.edu).
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The Journal of the American Board of Family     Medicine: 34 (2)
The Journal of the American Board of Family Medicine
Vol. 34, Issue 2
March/April 2021
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Treatment Differences in Primary and Specialty Settings in Veterans with Major Depression
Victor Puac-Polanco, Lucinda B. Leung, Robert M. Bossarte, Corey Bryant, Janelle N. Keusch, Howard Liu, Hannah N. Ziobrowski, Wilfred R. Pigeon, David W. Oslin, Edward P. Post, Ronald C. Kessler
The Journal of the American Board of Family Medicine Mar 2021, 34 (2) 268-290; DOI: 10.3122/jabfm.2021.02.200475

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Treatment Differences in Primary and Specialty Settings in Veterans with Major Depression
Victor Puac-Polanco, Lucinda B. Leung, Robert M. Bossarte, Corey Bryant, Janelle N. Keusch, Howard Liu, Hannah N. Ziobrowski, Wilfred R. Pigeon, David W. Oslin, Edward P. Post, Ronald C. Kessler
The Journal of the American Board of Family Medicine Mar 2021, 34 (2) 268-290; DOI: 10.3122/jabfm.2021.02.200475
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Keywords

  • Comorbidity
  • Depression
  • Integrated Health Care Systems
  • Mental Health Services
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