Send to

Choose Destination
See comment in PubMed Commons below
Am J Manag Care. 2004 Nov;10(11 Pt 2):846-51.

The relationship of system-level quality improvement with quality of depression care.

Author information

  • 1Division of General and Geriatric Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.



To explore the relationship of systemwide continuous quality improvement (CQI) with depression care quality in the Veterans Health Administration (VHA).


Observational study using data from 2 VHA studies.


The Depression Care Quality Study (DCQS) was a retrospective cohort study of depression care quality in the northeastern United States involving 12 678 patients cared for at 14 VHA facilities; it used guideline-based process measures (ie, dosage and duration adequacy). The VHA CQI survey was a cross-sectional survey of systemwide CQI among a representative sample of VHA hospitals; it assessed CQI and organizational culture (OC) at 116 VHA hospitals nationwide and provided data on the 14 study facilities. We used analysis of variance to identify differences in the adequacy of depression care among these facilities. Pearson's correlation was used to identify the relationship of CQI and OC with facility-level depression care adequacy.


Mean depression care adequacy differed among the 14 DCQS facilities (P < .0001). Overall dosage adequacy was 90% (range: 87%-92%). Overall duration adequacy was 45% (range: 39%-64%). There was no correlation between CQI and either dosage adequacy (r= .004, P= .98) or duration adequacy (r= -.17, P= .55). Similarly, there was no correlation between OC and either dosage adequacy (r= -.35, P= .22) or duration adequacy (r= -.12, P= .68).


Although CQI may help bridge the healthcare quality gap, it may not be associated with higher disease-specific quality of care.

[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Managed Care & Healthcare Communications, LLC
    Loading ...
    Support Center