--- title: "PCP propensity to assess sr pts for depression. | Sutter Health" description: "PCPs assessed elderly patients for depression infrequently, using data from videotapes and pt and MD surveys." url: "https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. PCP propensity to assess sr pts for depression. # Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data. Tai-Seale M, Bramson R, Drukker D, Hurwicz ML, Ory M, Tai-Seale T, Street R Jr, & Cook MA. _Med Care. 43(12):1217-24._ 2005-12-01 ## Abstract OBJECTIVE: The objective of this study was to examine primary care physicians' propensity to assess their elderly patients for depression using data from videotapes and patient and physician surveys. STUDY DESIGN: An observational study was informed by surveys of 389 patients and 33 physicians, and 389 videotapes of their clinical interactions. Secondary quantitative analyses used video data scored by the Assessment of Doctor-Elderly Patient Transactions system regarding depression assessment. A random-effects logit model was used to analyze the effects of patient health, competing demands, and racial and gender concordance on physicians' propensity to assess elderly patients for depression. RESULTS: Physicians assessed depression in only 14% of the visits. The use of formal depression assessment tools occurred only 3 times. White patients were almost 7 times more likely than nonwhite patients to be assessed for depression (odds ratio \[OR\], 6.9; P < 0.01). Depression assessment was less likely if the patient functioned better emotionally (OR, 0.95; P < 0.01). The propensity of depression assessment was higher in visits that covered multiple topics (OR, 1.3; P < 0.01) contrary to the notion of competing demands crowding out mental health services. Unexpectedly, depression assessment was less likely to occur in gender and racially concordant patient-physician dyads. CONCLUSIONS: Primary care physicians assessed their elderly patients for depression infrequently. Reducing the number of topics covered in visits and matching patients and physicians based on race and gender may be counterproductive to depression detection. Informed by videotapes and surveys, our findings offer new insights on the actual care process and present conclusions that are different from studies based on administrative or survey data alone. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/?term=tai-seale%2C+bramson%2C+2005) ## Research topics - [Aging and Longevity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Aging+and+Longevity%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Expressing uncertainty in clinical interactions between physicians and older patients: what matters?](https://www.sutterhealth.org/research/publications/expressing-uncertainty-in-clinical-interactions-1055312608) Tai-Seale M, Stults C, Zhang W, Shumway M. Patient Educ Couns. 86(3):322-8. doi: 10.1016/j.pec.2011.06.005. Epub 2011 Jul 20. 2012 Mar 01 - Publication ### [New Era Of Patient Engagement](https://www.sutterhealth.org/research/publications/new-era-of-patient-engagement-1055312777) Tai-Seale M. Health Affairs website. 2013 Feb 06 - Publication ### [Patient and physician race and the allocation of time and patient engagement efforts to mental health discussions in primary care: an observational study of audiorecorded periodic health examinations.](https://www.sutterhealth.org/research/publications/pt-md-race-empathy-mental-health-primary-care-1055312353) Foo PK, Frankel RM, McGuire TG, Zaslavsky AM, Lafata JE, Tai-Seale M. J Ambul Care Manage. doi: 10.1097/JAC.0000000000000176. \[Epub ahead of print\] 2017 Mar 27 - Publication ### [Two-minute mental health care for elderly patients: inside primary care visits.](https://www.sutterhealth.org/research/publications/two-minute-mental-health-care-for-elderly-patients-1055312643) Tai-Seale M, McGuire T, Colenda C, Rosen D, Cook MA. J Am Geriatr Soc. 55(12):1903-11. 2007 Dec 01 - Publication ### [How do primary care physicians respond when patients cry during routine ambulatory visits?](https://www.sutterhealth.org/research/publications/how-pcps-respond-when-pts-cry-in-outpt-visits-1055312766) Stults CD, Elston Lafata J, Diamond L, MacLean L, Stone AL, Wunderlich T, Frankel RM, Tai-Seale M. J Comm Healthcare. 7(1):17-24. DOI: http://dx.doi.org/10.1179/1753807614Y.0000000044 2014 Mar 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"PCP propensity to assess sr pts for depression."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561#medicalscholarlyarticle","name":"Understanding primary care physicians' propensity to assess elderly patients for depression using interaction and survey data.","headline":"PCP propensity to assess sr pts for depression.","abstract":"OBJECTIVE: The objective of this study was to examine primary care physicians' propensity to assess their elderly patients for depression using data from videotapes and patient and physician surveys. STUDY DESIGN: An observational study was informed by surveys of 389 patients and 33 physicians, and 389 videotapes of their clinical interactions. Secondary quantitative analyses used video data scored by the Assessment of Doctor-Elderly Patient Transactions system regarding depression assessment. A random-effects logit model was used to analyze the effects of patient health, competing demands, and racial and gender concordance on physicians' propensity to assess elderly patients for depression. RESULTS: Physicians assessed depression in only 14% of the visits. The use of formal depression assessment tools occurred only 3 times. White patients were almost 7 times more likely than nonwhite patients to be assessed for depression (odds ratio [OR], 6.9; P \u003c 0.01). Depression assessment was less likely if the patient functioned better emotionally (OR, 0.95; P \u003c 0.01). The propensity of depression assessment was higher in visits that covered multiple topics (OR, 1.3; P \u003c 0.01) contrary to the notion of competing demands crowding out mental health services. Unexpectedly, depression assessment was less likely to occur in gender and racially concordant patient-physician dyads. CONCLUSIONS: Primary care physicians assessed their elderly patients for depression infrequently. Reducing the number of topics covered in visits and matching patients and physicians based on race and gender may be counterproductive to depression detection. Informed by videotapes and surveys, our findings offer new insights on the actual care process and present conclusions that are different from studies based on administrative or survey data alone.","description":"PCPs assessed elderly patients for depression infrequently, using data from videotapes and pt and MD surveys.","keywords":["Aging and Longevity","Health Disparities","Health Services","Mental Health"],"datePublished":"2005-12-01","url":"https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561","inLanguage":"en-US","isPartOf":{"@type":"Periodical","name":"Med Care"},"author":[{"@type":"Person","name":"Tai-Seale M"},{"@type":"Person","name":"Bramson R"},{"@type":"Person","name":"Drukker D"},{"@type":"Person","name":"Hurwicz ML"},{"@type":"Person","name":"Ory M"},{"@type":"Person","name":"Tai-Seale T"},{"@type":"Person","name":"Street R Jr"},{"@type":"Person","name":"Cook MA"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Aging and Longevity","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Aging+and+Longevity%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Mental Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Mental+Health%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/pcp-propensity-assess-sr-pts-depression-1055312561#breadcrumblist"}}} ```