keyword: integrated care

Comparing Collaborative Care to Usual Care

Introduction:

Compared with usual care, Collaborative Care has been shown to improve the effectiveness of depression treatment and lower total healthcare costs. This handout outlines those differences using data from the IMPACT trial.

A printable PDF is available for download; however, please note that this document may not conform to the WCAG-2 accessibility standards.

Comparing Collaborative Care to Usual Care

The IMPACT (Improving Mood: Providing Access to Collaborative Treatment) trial focused on depressed, older adults. Half were randomly assigned to receive the depression treatment usually offered by participating clinics, and half were randomly assigned to receive collaborative care. Collaborative care more than doubled the effectiveness of depression treatment and reduced total healthcare costs at the same time (JAMA, 2002).

A bar graph titled "50% of Greater Improvement in Depression at 12 Months" compares the effectiveness of Usual Care and Collaborative Care across eight different clinics. The y-axis represents the percentage, ranging from 0% to 70%. The x-axis lists clinics numbered from 1 to 8. For each group, there are two bars: a green bar with diagonal stripes representing Usual Care and a solid blue bar representing Collaborative Care. In all groups, Collaborative Care shows higher percentages of improvement compared to Usual Care. A box around the bars above "7" points to text reading, "As part of usual care, patients at organization #7 were offered psychotherapy from master's-level clinicians co-located within the primary care clinic.

Usual Care

50% of study patients used antidepressants at the time of enrollment, but were still significantly depressed.

70% of usual care patients received medication therapy from their PCP and/or a referral to specialty behavioral health.

Only 20% of patients showed significant improvements after one year, which matches national data for depression treatment in primary care.

Collaborative Care

On average, twice as many patients significantly improved. The difference was statistically significant in all eight healthcare settings. Why?

  • Patient-Centered Team Care
  • Population-Based Care
  • Measurement-Based Treatment to Target
  • Evidence-Based Care
  • Accountable Care

Integrated Care: Creating Effective Mental and Primary Health Care Teams

Integrated Care: Creating Effective Mental Health and Primary Health Care Teams provides the first comprehensive guide for teams to integrate effective mental health care into primary care clinics. Edited by a team of UW Medicine mental health experts, it includes practical information, skills, and clinical approaches needed to implement Collaborative Care, an evidence-based model of integrated care developed at the University of Washington. Importantly, it provides a common resource and framework for all members of the care team including care managers, psychiatrists, primary care providers, and administrators. Editors include UW psychiatrists Anna Ratzliff, MD, PhD, Jurgen Unutzer, MD, PhD, MA, and the late Wayne Katon, MD, as well as UW psychologist Kari Stephens, PhD.

Find resources for implementation within the free Integrated Care Online Appendix. These include a CoCM readiness checklist, BHCM documentation templates with examples, job descriptions, links to screening and symptom monitoring tools, and more.

Email uwaims@uw.edu with specific questions.

Please note:

The Integrated Care Online Appendix can be found on the publisher’s website under ‘downloads’ at the bottom of the page.