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Why Cedars-Sinai Screens All Inpatient Adults for Depression

John Commins, for HealthLeaders Media, April 23, 2014

Risk factors that can adversely affect a patient's recovery or trigger a hospital readmission include behavioral issues. The chair of the Cedars-Sinai Department of Psychiatry discusses how screening for depression will become more widespread as hospitals adopt value-based reimbursement models.

By some estimates, about 18 million people in the United States, roughly 7% of the adult population, experience an episode of major depression each year. Undiagnosed and untreated, depression can have a profound effect on hospital patients who are also dealing with seemingly unrelated health issues.


Trotter


>Itai Danovitch, MD, MBA
Chair of the Cedars-Sinai Department of Psychiatry

With that in mind, Cedars-Sinai Medical Center in Los Angeles, CA announced this month that it has begun screening all adult inpatients for depression along other risk factors that could adversely affect their recovery.

Itai Danovitch, MD, MBA, chair of the Cedars-Sinai Department of Psychiatry, spoke with methis week about the need for screening, and how it will become more widespread as hospitals enter value-based reimbursement models. The following is an edited transcript.

HLM: Why did you start screening all inpatient adults for depression?

ID: At Cedars Sinai Medical Hospital the psychiatry department does a lot of consultations. That means that doctors call on us when there is a problem with a patient that they think is related to mental health and is affecting their medical care.

Depression is incredibly common and one of the things we know is that often, by the time we get called for helping a patient with depression, they have already had that depression for a period of time. If we could get calls earlier, or if the depression could get recognized sooner, there [would be] opportunities to intervene and help that patient earlier on.

That was our personal experience, and in reading the quite extensive literature on the prevalence of depression in patients with medical illness and also its impact on outcomes.

The rate of depression prevalence in patients who have medical disorders ranges from about 10% to 30% and in some diseases, such as cardiac disease, it is 30%. The presence of depression impacts basically every feature of a patient's medical care. It impacts their experience with care, their satisfaction with care, it impacts their adherence to care regimens. It impacts the disease outcomes from the medical diseases they are suffering from.

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