Comparing outcomes of routine care for depression: The dilemma of case-mixadjustment

The purpose of this study was to formulate and test two case-mix models for depression treatment that permit comparisons of patient outcomes across di verse clinical settings. It assessed demographics; eight, diagnostic-specif ic,case-mix variables; and clinical status at baseline and follow-up for 18 7 patients. Regressions were performed to test two models for four dependen t variables including depression severity and diagnosis. Individual treatme nt settings were then ranked based on a comparison of actual versus predict ed outcomes using regression coefficients and predictor variables. A model inclusive of baseline physical health status and depression severity, predi cted depression severity,, mental health, and physical health functioning a t follow-tip. A simpler model performed well in predicting depression remis sion. This study identifies variables to be included in case-mix adjustment models and demonstrates statistical methods to control for differences acr oss settings when comparing depression outcomes.