DESCRIPTION: 

Patients age 18 and older with major depression or dysthymia and an initial Patient Health Questionnaire (PHQ-9) score greater than nine who demonstrate remission at twelve months (+/- 30 days after an index visit) defined as a PHQ-9 score less than five. This measure applies to both patients with newly diagnosed and existing depression whose current PHQ-9 score indicates a need for treatment


IMPROVEMENT NOTATION: 

Higher score indicates better quality


INITIAL POPULATION:

Patients age 18 and older with a diagnosis of major depression or dysthymia and an initial PHQ-9 score greater than nine during the index visit


DENOMINATOR:

Equals Initial Population


DENOMINATOR EXCLUSIONS: 

Patients who died
Patients who received hospice or palliative care services
Patients who were permanent nursing home residents
Patients with a diagnosis of bipolar disorder
Patients with a diagnosis of personality disorder


DENOMINATOR EXCEPTIONS: 

None


NUMERATOR:

Patients who achieved remission at twelve months as demonstrated by a twelve month (+/- 30 days grace period) PHQ-9 score of less than five


NUMERATOR EXCLUSIONS: 

Not Applicable


DEFINITIONS:
Index Date - the first instance (12/1/2015 to 11/30/2016) of elevated PHQ-9 greater than nine and diagnosis of depression or dysthymia.
Remission - is defined as a PHQ-9 score of less than five.
Twelve Months - is defined as the point in time from the date that a patient meets the Initial Population inclusion criteria (diagnosis and PHQ-9 score greater than nine) extending out twelve months and then allowing a grace period of thirty days prior to and thirty days after this date. The most recent PHQ-9 score less than five obtained during this two month period is deemed as remission at twelve months, values obtained prior to or after this period are not counted as numerator compliant (remission).