Improving Care for Late-Life Depression Through Partnerships With Community-Based Organizations: Results From the Care Partners Project.

Objectives: Collaborative care (CC) has demonstrated effectiveness for improving late-life depression in primary care, but clinics offering this service can find it challenging to address unmet social needs that may be contributing to their patients' depression. Clinics may benefit from better coordination and communication with community-based organizations (CBO) to strengthen depression treatment and to address unmet social needs. We evaluated the feasibility of adding a CBO to enhance standard collaborative care and the impact of such partnered care on older adults.

How to Exercise Integrity in Medical Billing: Don't Distort Prices, Don't Free-Ride on Other Physicians.

This paper proposes that billing gamesmanship occurs when physicians free-ride on the billing practices of other physicians. Gamesmanship is non-universalizable and does not exercise a competitive advantage; consequently, it distorts prices and allocates resources inefficiently. This explains why gamesmanship is wrong.

Myelin oligodendrocyte glycoprotein (MOG) antibody-mediated disease: The difficulty of predicting relapses.

Background: While many patients with myelin oligodendrocyte glycoprotein antibody-mediated disease (MOG-AD) will have a monophasic course, 30-80% of patients will relapse after the initial attack. It is not known which factors predict relapse. Here we describe our clinical experience with MOG-AD and evaluate for factors that correlate with relapsing disease.

The Hartford Geriatric Nursing Initiative: developing a focused strategy and strong partnerships to improve nursing care for older adults.

This article traces the funding priorities of the John A. Hartford Foundation--the largest private philanthropy in the United States dedicated to aging and health--to increase the competence of the health care workforce (physicians, nurses, and social workers) to care for our aging society. A review of the Foundation's 15-year and over $70 million investment in geriatric nursing is presented with emphasis on 2 critical factors--a focused strategy and strong partnerships--to build the nation's nursing capacity to meet the health care needs of older Americans.

Symptoms, affects, and self-rated health: evidence for a subjective trajectory of health.

Objective: Self-rated health (SRH) is known to predict mortality and other health outcomes better than objective ratings, suggesting that patients have important knowledge that physicians do not. The study assessed whether SRH reflects changes in internal states, specifically symptoms and affects.

Method: In an event-sampling study, 54 elders completed a SRH measure, positive and negative affect scale, a symptom checklist, and a pain scale every evening for 8 weeks.

Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients.

Background: Acutely ill older persons often experience adverse events when cared for in the acute care hospital.

Objective: To assess the clinical feasibility and efficacy of providing acute hospital-level care in a patient's home in a hospital at home.

Design: Prospective quasi-experiment.

Cost-effectiveness of improving primary care treatment of late-life depression.

Context: Depression is a leading cause of functional impairment in elderly individuals and is associated with high medical costs, but there are large gaps in quality of treatment in primary care.

Objective: To determine the incremental cost-effectiveness of the Improving Mood Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression.

Design: Randomized controlled trial with recruitment from July 1999 to August 2001.

Physicians' satisfaction with a collaborative disease management program for late-life depression in primary care.

Objective: This study describes physicians' satisfaction with care for patients with depression before and after the implementation of a primary care-based collaborative care program.

Method: Project Improving Mood, Promoting Access to Collaborative Treatment for late-life depression (IMPACT) is a multisite, randomized controlled trial comparing a primary care-based collaborative disease management program for late-life depression with care as usual. A total of 450 primary care physicians at 18 participating clinics participated in a satisfaction survey before and 12 months after IMPACT initiation.

Decades of focus: grant making at the John A. Hartford Foundation.

Foundation grant making can play an important role in advancing the U.S. health agenda.

Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial.

Context: Few depressed older adults receive effective treatment in primary care settings.

Objective: To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression.

Design: Randomized controlled trial with recruitment from July 1999 to August 2001.