Kathryn Rost
Dados Biográficos
| ID | 3929097 |
|---|---|
| NOME | Kathryn Rost |
| PRENOMES | Kathryn |
| SOBRENOME | Rost |
| ASSINATURA | ROST K |
| AFILIAÇÕES | University of Arkansas for Medical Sciences |
| VERIFICADO | Não |
| TOTAL DE OBRAS | 26 |
| TOTAL DE CITAÇÕES | 17 |
| TOTAL COMO AUTOR | 26 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1989 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2009 |
| ÍNDICE H | 3 |
Diagnostic Accuracy of Predicting Somatization From Patients’ ICD-9 Diagnoses
OBJECTIVES: To hypothesize in a new and different population that administrative database (ADB) screening would identify somatizing patients by increasing numbers of visits, female gender, and greater percent of International Classification of Diseases, 9th Edition (ICD-9) primary diagnosis codes in musculoskeletal, nervous, gastrointestinal (GI), and ill-defined body systems. We labeled these codes as having "somatization potential." Our earlier…
Testing for Statistical Discrimination by Race/Ethnicity in Panel Data for Depression Treatment in Primary Care
Enhanced physician-patient communication and use of standardized depression instruments may reduce statistical discrimination arising from clinical uncertainty and be useful in reducing racial/ethnic inequities in depression treatment
Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients
Context: Federally qualified health centers across the country are adopting depression disease management programs following federally mandated training; however, little is known about the relative effectiveness of depression disease management in rural versus urban patient populations. Purpose: To explore whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urb…
Modeling the Impact of Enhanced Depression Treatment on Workplace Functioning and Costs
BACKGROUND: The impact of depression on the workplace has been widely observed in studies examining absenteeism and reduced productivity during days at work. However, there is little scientific evidence about whether depression interventions are cost-beneficial to employers. OBJECTIVE: We construct a cost-benefit analysis of depression treatment under different workplace assumptions better reflecting the nature of employment. RESEARCH DESIGN: Dat…
Primary Care Patients’ Involvement in Decision-Making Is Associated With Improvement in Depression
BACKGROUND: Depression is undertreated in primary care settings. Little research investigates the impact of patient involvement in decisions on guideline-concordant treatment and depression outcomes. OBJECTIVE: The objective of this study was to determine whether patient involvement in decision-making is associated with guideline-concordant care and improvement in depression symptoms. DESIGN: Prospective cohort study. SETTING: Multisite, nationwi…
Response to Letter From Dr Raj Persaud
University of Illinois at Chicago Chicago, Illinois (Lo Sasso) Florida State University College of Medicine Tallahassee, Florida (Rost) Kaiser Permanente Aurora, Colorado (Beck)
The Effect of Improving Primary Care Depression Management on Employee Absenteeism and Productivity
OBJECTIVE: To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. SETTING AND SUBJECTS: Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. RESEARCH DESIGN: Practices were stratified by depression treatment patterns before randomization to enhanced or usual care. After delivering brief…
The Acceptability of Treatment for Depression Among African-American, Hispanic, and White Primary Care Patients
BACKGROUND: Ethnic minority patients are less likely than white patients to receive guideline-concordant care for depression. It is uncertain whether racial and ethnic differences exist in patient beliefs, attitudes, and preferences for treatment. METHODS: A telephone survey was conducted of 829 adult patients (659 non-Hispanic whites, 97 African Americans, 73 Hispanics) recruited from primary care offices across the United States who reported 1 …
Impact of Ongoing Primary Care Intervention on Long Term Outcomes In Uninsured and Insured Patients With Depression
BACKGROUND AND OBJECTIVES: To assess the differential impact of an ongoing primary care depression intervention on uninsured and insured patients' outcomes 12, 18, and 24 months following baseline. RESEARCH DESIGN: Quasi-experimental longitudinal study of insured and uninsured patients with depression receiving treatment from 12 practices randomized to enhanced (intervention) and usual care study conditions. SUBJECTS: In 1996 to 1997, 383 nonelde…
Resolving Disparities in Antidepressant Treatment and Quality-of-Life Outcomes Between Uninsured and Insured Primary Care Patients With Depression
BACKGROUND: Efforts to improve primary care depression treatment should penetrate to vulnerable uninsured populations. OBJECTIVE: To assess a primary care intervention's impact on treatment and quality-of-life outcomes in uninsured and insured depressed patients during the acute treatment phase. RESEARCH DESIGN: Twelve community primary care practices were randomized to 'enhanced' (intervention) and usual care conditions. Physicians, nurses and a…
A Primary Care Intervention for Depression
To assess a guideline‐based intervention's impact on depression care provided in rural vs. urban primary care settings, 12 community primary care practices (four rural, eight urban) were randomized to enhanced (i.e, intervention) and usual care study conditions. The study enrolled 479 depressed patients, with 432 (90.2 percent) completing telephone follow‐up at six months. Multilevel analytic models revealed that rural enhanced care patients had …
Treatment of Depression in Rural Arkansas
Policy‐makers have long suspected that greater barriers to care result in depressed rural residents being less likely to receive high‐quality treatment. This study recruited 470 depressed community residents in a 1992 telephone survey, followed 95 percent of them through one year, and abstracted additional data on their health care utilization from insurance claims, medical and pharmacy records. Bivariate and multivariate models demonstrated that…
Depression Treatment and Cost Offset for Rural Community Residents with Depression
This study examined the relationship between costs of treating physical problems and costs of treating depression, for 322 rural residents with depression. Multiple regressions were used to control for sociodemographics, depression severity, and physical and mental health comorbidities at baseline. The results indicated a $1.42 (n = 322) reduction in the costs of treating physical problems for a $1.00 increase in the costs of treating depression.…
The Impact of Geographic Accessibility on the Intensity and Quality of Depression Treatment
OBJECTIVES: For depression, this research measures the impact of travel time on visit frequency and the probability of receiving treatment in concordance with AHCPR guidelines. METHODS: The medical, insurance, and pharmacy records of a community-based sample of 435 subjects with current depression were abstracted to identify those treated for depression, to determine the number of depression visits made over a 6-month period, and to ascertain whe…
Rural‐Urban Differences in Service Use and Course of Illness in Bipolar Disorder
Policy analysts have long been concerned that the reduced availability of mental health professionals in rural areas prohibits rural individuals from getting the care they need for serious psychiatric conditions like bipolar disorder. Through a community‐based telephone survey, the researchers recruited 54 subjects with bipolar disorder who were currently experiencing depressive episodes. Forty‐six (85.1%) of them were reinterviewed one year afte…
Rural-Urban Differences in Depression Treatment and Suicidality
OBJECTIVES: Because there are fewer per capita providers trained to deliver mental health services in rural areas, the authors hypothesized that depressed rural individuals would receive less outpatient treatment and report higher rates of hospital admittance and suicide attempts than their urban counterparts. METHODS: The authors recruited 74% of eligible participants (n = 470) from a 1992 telephone survey and followed up 95% of subjects for 1 y…
A Joint Choice Model of the Decision to Seek Depression Treatment and Choice of Provider Sector
OBJECTIVES: Using a community-based sample of currently depressed subjects, this research modeled the joint decision to seek depression treatment and choice of provider sector (primary care or specialty mental health). The objective was to identify those subject-specific case-mix factors and those provider sector-specific access measures that significantly impacted this joint decision. METHODS: A community-based sample of 435 Arkansans with curre…
Does This Treatment Work
The purpose of this study was to evaluate the outcomes of routine care administered to alcohol-dependent inpatients. The authors sought to validate a self-administered instrument that measures the types and extent of care delivered, the outcomes of that care, and casemix characteristics that influence the outcomes of care. Seventy-eight patients who were beginning inpatient treatment for alcohol dependence were recruited; 85% were followed 5 mont…
The Process and Outcomes of Care for Major Depression in Rural Family Practice Settings
Although primary care physicians provide the majority of care for rural residents with major depression, little is known about the quality of the care they provide. The aim of this study was to characterize the process and outcomes of care for rural patients with major depression, and to examine the relationship between the process and outcomes of care in this population. Six hundred and thirty‐one patients in 21 primary care practices in small t…
Rural‐Urban Differences in Stigma and the Use of Care for Depressive Disorders
Stigma may be a particularly important barrier to mental health care in rural communities where lack of anonymity increases the probability that someone who seeks care will be labeled “crazy.” This study examined rural‐urban differences in the stigma associated with depressive symptoms and the stigma associated with seeking treatment for depressive disorders. In addition, the study compared how the stigma associated with seeking treatment predict…
The Introduction of the Older Patient's Problems in the Medical Visit
In this study of 100 diabetes patients 60 years old or older making return medical visits, 56% of patients reported one or more important medical problems that were never raised with their doctor. Sixty percent of patients reported important psychosocial problems that were never raised. One quarter of all patients were not able to raise even modest agendas of medical problems during the visit. These gaps in doctor-patient communication potentiall…
Development of Screeners for Depressive Disorders and Substance Disorder History
If screeners are going to be widely incorporated in clinical care to increase the detection of common psychiatric disorders, they need to be brief, easy to score, and sensitive across diverse patient populations. Few screeners exist that meet these criteria. This problem is addressed in this study by identifying a subset of questions from the Diagnostic Interview Schedule (DIS), which predicted simultaneously obtained DIS diagnoses. A two-item sc…
Measuring the Outcomes of Care for Mental Health Problems
To conduct effectiveness research in mental health, many nontrivial problems need to be addressed. A multidisciplinary expert panel designed an outcomes module for major depression and dysthymia to measure disease-specific outcomes, treatments routinely provided, and patient characteristics that influence treatment or its outcomes. The outcomes module was pilot-tested to evaluate its ability to identify a diagnostically homogeneous group of patie…
An Analysis of Panel Data
In this study, the cost and health outcomes of a psychiatric consultation letter to primary care physicians caring for a sample of patients diagnosed with somatization disorder, a psychiatric condition associated with multiple, unexplained medical complaints, was assessed. To accommodate the small sample size of 73 patients, outcome effects were calculated using panel analysis. Study patients were randomized to a consultation or noconsultation gr…
Measuring physical activity with a single question
Using 1,004 subjects enrolled in a worksite health promotion program, this report evaluated the validity of a single question about participation in regular exercise. Measured at baseline, this one question had a significant age-adjusted association with body mass index (p less than 0.0001 in women and p = 0.001 in men), HDL cholesterol (p less than 0.0001 in women), and oxygen capacity (p = 0.0007 in women and p = 0.002 in men). Thus, one self-r…
Testing for Statistical Discrimination by Race/Ethnicity in Panel Data for Depression Treatment in Primary Care
Enhanced physician-patient communication and use of standardized depression instruments may reduce statistical discrimination arising from clinical uncertainty and be useful in reducing racial/ethnic inequities in depression treatment
Introduction of information during the initial medical visit
Measuring physical activity with a single question
Using 1,004 subjects enrolled in a worksite health promotion program, this report evaluated the validity of a single question about participation in regular exercise. Measured at baseline, this one question had a significant age-adjusted association with body mass index (p less than 0.0001 in women and p = 0.001 in men), HDL cholesterol (p less than 0.0001 in women), and oxygen capacity (p = 0.0007 in women and p = 0.002 in men). Thus, one self-r…
The Introduction of the Older Patient's Problems in the Medical Visit
In this study of 100 diabetes patients 60 years old or older making return medical visits, 56% of patients reported one or more important medical problems that were never raised with their doctor. Sixty percent of patients reported important psychosocial problems that were never raised. One quarter of all patients were not able to raise even modest agendas of medical problems during the visit. These gaps in doctor-patient communication potentiall…
Introduction of information during the initial medical visit
Measuring physical activity with a single question
Using 1,004 subjects enrolled in a worksite health promotion program, this report evaluated the validity of a single question about participation in regular exercise. Measured at baseline, this one question had a significant age-adjusted association with body mass index (p less than 0.0001 in women and p = 0.001 in men), HDL cholesterol (p less than 0.0001 in women), and oxygen capacity (p = 0.0007 in women and p = 0.002 in men). Thus, one self-r…
Measuring the Outcomes of Care for Mental Health Problems
To conduct effectiveness research in mental health, many nontrivial problems need to be addressed. A multidisciplinary expert panel designed an outcomes module for major depression and dysthymia to measure disease-specific outcomes, treatments routinely provided, and patient characteristics that influence treatment or its outcomes. The outcomes module was pilot-tested to evaluate its ability to identify a diagnostically homogeneous group of patie…
An Analysis of Panel Data
In this study, the cost and health outcomes of a psychiatric consultation letter to primary care physicians caring for a sample of patients diagnosed with somatization disorder, a psychiatric condition associated with multiple, unexplained medical complaints, was assessed. To accommodate the small sample size of 73 patients, outcome effects were calculated using panel analysis. Study patients were randomized to a consultation or noconsultation gr…
Rural‐Urban Differences in Stigma and the Use of Care for Depressive Disorders
Stigma may be a particularly important barrier to mental health care in rural communities where lack of anonymity increases the probability that someone who seeks care will be labeled “crazy.” This study examined rural‐urban differences in the stigma associated with depressive symptoms and the stigma associated with seeking treatment for depressive disorders. In addition, the study compared how the stigma associated with seeking treatment predict…
The Introduction of the Older Patient's Problems in the Medical Visit
In this study of 100 diabetes patients 60 years old or older making return medical visits, 56% of patients reported one or more important medical problems that were never raised with their doctor. Sixty percent of patients reported important psychosocial problems that were never raised. One quarter of all patients were not able to raise even modest agendas of medical problems during the visit. These gaps in doctor-patient communication potentiall…
Development of Screeners for Depressive Disorders and Substance Disorder History
If screeners are going to be widely incorporated in clinical care to increase the detection of common psychiatric disorders, they need to be brief, easy to score, and sensitive across diverse patient populations. Few screeners exist that meet these criteria. This problem is addressed in this study by identifying a subset of questions from the Diagnostic Interview Schedule (DIS), which predicted simultaneously obtained DIS diagnoses. A two-item sc…
The Process and Outcomes of Care for Major Depression in Rural Family Practice Settings
Although primary care physicians provide the majority of care for rural residents with major depression, little is known about the quality of the care they provide. The aim of this study was to characterize the process and outcomes of care for rural patients with major depression, and to examine the relationship between the process and outcomes of care in this population. Six hundred and thirty‐one patients in 21 primary care practices in small t…
Does This Treatment Work
The purpose of this study was to evaluate the outcomes of routine care administered to alcohol-dependent inpatients. The authors sought to validate a self-administered instrument that measures the types and extent of care delivered, the outcomes of that care, and casemix characteristics that influence the outcomes of care. Seventy-eight patients who were beginning inpatient treatment for alcohol dependence were recruited; 85% were followed 5 mont…
Rural‐Urban Differences in Service Use and Course of Illness in Bipolar Disorder
Policy analysts have long been concerned that the reduced availability of mental health professionals in rural areas prohibits rural individuals from getting the care they need for serious psychiatric conditions like bipolar disorder. Through a community‐based telephone survey, the researchers recruited 54 subjects with bipolar disorder who were currently experiencing depressive episodes. Forty‐six (85.1%) of them were reinterviewed one year afte…
Rural-Urban Differences in Depression Treatment and Suicidality
OBJECTIVES: Because there are fewer per capita providers trained to deliver mental health services in rural areas, the authors hypothesized that depressed rural individuals would receive less outpatient treatment and report higher rates of hospital admittance and suicide attempts than their urban counterparts. METHODS: The authors recruited 74% of eligible participants (n = 470) from a 1992 telephone survey and followed up 95% of subjects for 1 y…
A Joint Choice Model of the Decision to Seek Depression Treatment and Choice of Provider Sector
OBJECTIVES: Using a community-based sample of currently depressed subjects, this research modeled the joint decision to seek depression treatment and choice of provider sector (primary care or specialty mental health). The objective was to identify those subject-specific case-mix factors and those provider sector-specific access measures that significantly impacted this joint decision. METHODS: A community-based sample of 435 Arkansans with curre…
Treatment of Depression in Rural Arkansas
Policy‐makers have long suspected that greater barriers to care result in depressed rural residents being less likely to receive high‐quality treatment. This study recruited 470 depressed community residents in a 1992 telephone survey, followed 95 percent of them through one year, and abstracted additional data on their health care utilization from insurance claims, medical and pharmacy records. Bivariate and multivariate models demonstrated that…
Depression Treatment and Cost Offset for Rural Community Residents with Depression
This study examined the relationship between costs of treating physical problems and costs of treating depression, for 322 rural residents with depression. Multiple regressions were used to control for sociodemographics, depression severity, and physical and mental health comorbidities at baseline. The results indicated a $1.42 (n = 322) reduction in the costs of treating physical problems for a $1.00 increase in the costs of treating depression.…
The Impact of Geographic Accessibility on the Intensity and Quality of Depression Treatment
OBJECTIVES: For depression, this research measures the impact of travel time on visit frequency and the probability of receiving treatment in concordance with AHCPR guidelines. METHODS: The medical, insurance, and pharmacy records of a community-based sample of 435 subjects with current depression were abstracted to identify those treated for depression, to determine the number of depression visits made over a 6-month period, and to ascertain whe…
A Primary Care Intervention for Depression
To assess a guideline‐based intervention's impact on depression care provided in rural vs. urban primary care settings, 12 community primary care practices (four rural, eight urban) were randomized to enhanced (i.e, intervention) and usual care study conditions. The study enrolled 479 depressed patients, with 432 (90.2 percent) completing telephone follow‐up at six months. Multilevel analytic models revealed that rural enhanced care patients had …
Resolving Disparities in Antidepressant Treatment and Quality-of-Life Outcomes Between Uninsured and Insured Primary Care Patients With Depression
BACKGROUND: Efforts to improve primary care depression treatment should penetrate to vulnerable uninsured populations. OBJECTIVE: To assess a primary care intervention's impact on treatment and quality-of-life outcomes in uninsured and insured depressed patients during the acute treatment phase. RESEARCH DESIGN: Twelve community primary care practices were randomized to 'enhanced' (intervention) and usual care conditions. Physicians, nurses and a…
Impact of Ongoing Primary Care Intervention on Long Term Outcomes In Uninsured and Insured Patients With Depression
BACKGROUND AND OBJECTIVES: To assess the differential impact of an ongoing primary care depression intervention on uninsured and insured patients' outcomes 12, 18, and 24 months following baseline. RESEARCH DESIGN: Quasi-experimental longitudinal study of insured and uninsured patients with depression receiving treatment from 12 practices randomized to enhanced (intervention) and usual care study conditions. SUBJECTS: In 1996 to 1997, 383 nonelde…
The Acceptability of Treatment for Depression Among African-American, Hispanic, and White Primary Care Patients
BACKGROUND: Ethnic minority patients are less likely than white patients to receive guideline-concordant care for depression. It is uncertain whether racial and ethnic differences exist in patient beliefs, attitudes, and preferences for treatment. METHODS: A telephone survey was conducted of 829 adult patients (659 non-Hispanic whites, 97 African Americans, 73 Hispanics) recruited from primary care offices across the United States who reported 1 …
The Effect of Improving Primary Care Depression Management on Employee Absenteeism and Productivity
OBJECTIVE: To test whether an intervention to improve primary care depression management significantly improves productivity at work and absenteeism over 2 years. SETTING AND SUBJECTS: Twelve community primary care practices recruiting depressed primary care patients identified in a previsit screening. RESEARCH DESIGN: Practices were stratified by depression treatment patterns before randomization to enhanced or usual care. After delivering brief…
Differential Effectiveness of Depression Disease Management for Rural and Urban Primary Care Patients
Context: Federally qualified health centers across the country are adopting depression disease management programs following federally mandated training; however, little is known about the relative effectiveness of depression disease management in rural versus urban patient populations. Purpose: To explore whether a depression disease management program has a comparable impact on clinical outcomes over 2 years in patients treated in rural and urb…
Modeling the Impact of Enhanced Depression Treatment on Workplace Functioning and Costs
BACKGROUND: The impact of depression on the workplace has been widely observed in studies examining absenteeism and reduced productivity during days at work. However, there is little scientific evidence about whether depression interventions are cost-beneficial to employers. OBJECTIVE: We construct a cost-benefit analysis of depression treatment under different workplace assumptions better reflecting the nature of employment. RESEARCH DESIGN: Dat…
Primary Care Patients’ Involvement in Decision-Making Is Associated With Improvement in Depression
BACKGROUND: Depression is undertreated in primary care settings. Little research investigates the impact of patient involvement in decisions on guideline-concordant treatment and depression outcomes. OBJECTIVE: The objective of this study was to determine whether patient involvement in decision-making is associated with guideline-concordant care and improvement in depression symptoms. DESIGN: Prospective cohort study. SETTING: Multisite, nationwi…
Response to Letter From Dr Raj Persaud
University of Illinois at Chicago Chicago, Illinois (Lo Sasso) Florida State University College of Medicine Tallahassee, Florida (Rost) Kaiser Permanente Aurora, Colorado (Beck)
Testing for Statistical Discrimination by Race/Ethnicity in Panel Data for Depression Treatment in Primary Care
Enhanced physician-patient communication and use of standardized depression instruments may reduce statistical discrimination arising from clinical uncertainty and be useful in reducing racial/ethnic inequities in depression treatment
Medicine (25 obras) · Mental Health Treatment and Access (19 obras) · Psychiatry (17 obras) · Mental health (13 obras) · Family medicine (12 obras) · Depression (economics) (11 obras) · Internal Medicine (11 obras) · Nursing (9 obras) · Primary Care and Health Outcomes (8 obras) · Psychology (8 obras)