Article Figures & Data
Figures
- Figure 1.
CONSORT diagram. Abbreviations: PPA, Practice Participation Agreement; MOU, Memorandum of Understanding.
- Figure 2.
Improvement in depression screening and treatment quality measures.
Tables
Cohort 1 N = 95 Cohort 2 N = 155 Cohort 3 N = 84 Total N = 334 N (%) or mean (SD) N (%) or mean (SD) N (%) or mean (SD) N (%) or mean (SD) P-value Organization type <0.0001 FQHC 22 (23.2) 49 (31.6) 11 (13.4) 82 (24.6) HMO 1 (1.1) 0 (0) 3 (3.6) 4 (1.2) Hospital/system 25 (26.3) 24 (15.5) 12 (14.3) 61 (18.3) School-based clinic 3 (3.2) 19 (12.3) 4 (4.8) 26 (7.8) Private 44 (46.3) 63 (40.7) 54 (64.3) 161 (48.2) Ages served 0.0008 Adults only 11 (11.6) 5 (3.2) 17 (20.2) 33 (9.9) All ages 63 (66.3) 112 (72.3) 46 (54.8) 221 (66.2) Children only 21 (22.1) 38 (24.5) 21 (25.0) 80 (24.0) Size <0.0001 Large 46 (48.4) 31 (20.0) 20 (23.8) 97 (29.0) Medium 27 (28.4) 51 (32.9) 25 (29.8) 103 (30.8) Small 22 (23.2) 73 (47.1) 39 (46.4) 134 (40.1) Visits per year 17,288 (13184) 10,843 (14119) 11,237 (11237) 12,773 (15007) 0.0024 Rural location 24 (25.3) 58 (37.4) 19 (22.6) 101 (30.2) 0.0271 Percent uninsured 10.0 (14.2) 11.4 (13.6) 6.9 (10.3) 9.9 (13.1) 0.0421 Percent medicaid 32.8 (26.8) 36.8 (25.8) 28.8 (23.3) 33.6 (25.6) 0.0651 Abbreviations: FQHC, Federally Qualified Health Center; HMO, Health Maintenance Organization; SD, Standard Deviation.
Building Block Baseline N = 333 Estimate (SE) One-year N = 324 Estimate (SE) Two-year N = 237 Estimate (SE) P-value for change Engaged leadership 73.9 (1.6) 85.4 (1.6) 88.0 (1.7) 0.0005 Data driven improvement 68.2 (1.7) 86.6 (1.7) 90.1 (1.8) <0.0001 Empanelment 72.7 (2.1) 87.6 (2.1) 92.6 (2.3) <0.0001 Team based care 70.7 (1.8) 85.0 (1.8) 89.0 (1.9) 0.0223 Patient team partnership 61.3 (1.8) 76.6 (1.8) 82.6 (1.9) 0.0420 Population management 67.0 (1.9) 82.1 (1.9) 89.2 (2.0) <0.0001 Continuity of care 72.3 (2.4) 84.7 (2.4) 88.0 (2.5) <0.0001 Access to care 80.8 (1.5) 88.3 (1.5) 90.4 (1.6) <0.0001 Care coordination 64.2 (2.0) 79.9 (2.0) 89.3 (2.1) <0.0001 Resource utilization 53.6 (1.9) 68.3 (1.0) 76.6 (2.1) <0.0001 Behavioral health improvement 62.2 (1.7) 79.5 (1.7) 87.8 (1.8) <0.0001 Behavioral health integration 56.9 (2.7) 77.4 (2.7) 88.1 (2.8) <0.0001 Abbreviation: SE, Standard Error.
+P-value refers to overall change across all three timepoints; adjusted for rurality, size, cohort, ages served (children only, mixed, adult only), size.
- Table 3.
Additional Change per Year by 10-point Improvement in Building Block Implementation*
Maternal Depression Screening N = 84 Depression Screening and Follow-up N = 318 Coef (SE)± P-value Coef (SE)± P-value Total score 0.1372 (0.0309) <0.0001 0.1409 (0.0149) <0.0001 Leadership 0.0004 (0.0100) 0.9705 −0.0045 (0.0057) 0.4286 Data driven improvement −0.0036 (0.0176) 0.8381 0.0168 (0.0070) 0.0159 Empanelment 0.0143 (0.0105) 0.1759 0.0095 (0.0054) 0.0824 Team-based care 0.0007 (0.0106) 0.9473 0.0070 (0.0059) 0.2299 Patient team partnership −0.0080 (0.0101) 0.4283 0.0127 (0.0054) 0.0187 Population management 0.0055 (0.0093) 0.5518 0.0119 (0.0052) 0.0207 Continuity of care 0.0063 (0.0078) 0.4173 0.0101 (0.0041) 0.0135 Access −0.0080 (0.0149) 0.5915 0.0128 (0.0064) 0.0472 Coordination of care 0.0047 (0.0113) 0.6751 0.0139 (0.0050) 0.0051 Resource utilization 0.0216 (0.0092) 0.0194 0.0109 (0.0043) 0.0115 Behavioral health improvement 0.0137 (0.0118) 0.2470 0.0162 (0.0060) 0.0071 Behavioral health integration 0.0119 (0.0067) 0.0777 0.0150 (0.0039) 0.0001 Abbreviation: SE, Standard Error.
*General linear mixed model with adjustments for location (rural/urban), organization type, ages served, cohort, and size. Statistically significant results are bolded and italicized.
±Per 10 point improvement in Building Block.
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