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Research Article

Using the Electronic Medical Record to Examine Racial and Ethnic Differences in Depression Diagnosis and Treatment in a Primary Care Population

Nhi-Ha T. Trinh1*, Rachel LaRocca1, Susan Regan2, Trina E. Chang1, Stephen E. Gilman ScD3,4,5, Maurizio Fava1 and Albert Yeung1,6

1Depression Clinical & Research Program, Massachusetts General Hospital, One Bowdoin Square, 6th floor, Boston, MA 02114, USA

2Division of Internal Medicine, Massachusetts General Hospital, 50 Staniford Street, 9th Floor, Boston, MA 02114, USA

3Department of Society, Human Development, and Health, Harvard School of Public Health, 677 Huntington Avenue Boston, MA 02115, USA

4Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue Boston, MA 02115, USA

5Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street Boston MA 02114, USA

6South Cove Community Health Center, 885 Washington St Boston, MA 02111, USA

Corresponding Author:
Nhi-Ha Trinh MD MPH
Depression Clinical and Research Program
Massachusetts General Hospital, One Bowdoin Square
Boston, MA 02114, USA
Tel: (617) 724-4279
Fax: (617) 724-3028
E-mail: [email protected]

Received date: December 01, 2011; Accepted date: January 02, 2012; Published date:January 04, 2012

Citation: Trinh NHT, LaRocca R, Regan S, Chang TE, Gilman SE, et al. (2011) Using the Electronic Medical Record to Examine Racial and Ethnic Differences in Depression Diagnosis and Treatment in a Primary Care Population. Primary Health Care: Open Access 1:106. doi:10.4172/2167-1079.1000106

Copyright: © 2011 Trinh NHT, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: We assessed racial and ethnic differences in depression diagnosis and treatment in a primary care population. Methods: A sample of primary care outpatients in 2007 was generated using the electronic medical record (EMR). Patients were considered depressed if their providers billed for depression-related codes; they were considered prescribed antidepressants if any antidepressants were on their medication list. Rates of diagnosis and medication prescription were estimated using a generalized linear model with a Poisson distribution, adjusting for covariates. Results: In the resulting sample (n=85,790), all minority groups were less likely to be diagnosed with depression as compared to Whites (p<0.05); 11.36% of Whites had a depression diagnosis, as compared to 6.44% of Asian Americans, 7.55% of African Americans, and 10.18% of Latino Americans. Among those with a depression diagnosis (n=11,096), 54.07% of African Americans were prescribed antidepressant medications, as compared to 63.19% Whites (p<0.05); Asian Americans and Latino Americans showed a trend of being less likely to be prescribed antidepressant medications. Conclusions: Our study illustrates differences in diagnosis and treatment for minority primary care patients, and is innovative in using the EMR to probe these differences. Further research is needed to understand the underlying reasons for these observed differences.

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