Relationship of depression screening and physician office visit duration in a national sample

Abstract

Objective: Although depression screening in primary care is recommended by the U.S. Preventive Services Task Force, it may increase the duration of primary care physician visits that are often at or exceeding capacity. This study was conducted to evaluate the relationship between depression screening and physician visit duration in community-based, primary care physician office visits while controlling for important covariates.

Methods: Cross-sectional data from the 2005-2007 National Ambulatory Medical Care Survey were used to examine the relationship between physician-indicated depression screening and office visit duration among adults (≥18 years of age) with multivariable, ordered logistic regression. Predicted probabilities of visit duration (by 15-minute increments of one to 15, 16-30, 31-45, and 46-60 minutes) were estimated for visits where depression screening was and was not documented.

Results: In a sample of 14,736 physician office visits, representing an estimated population of more than 641 million visits, depression screening was significantly associated with increased visit duration (adjusted odds ratio=3.66, 95% confidence interval=2.25-5.95). A prominent shift in the proportion of visits that were from one to 15 minutes long to visits that were at least 16-30 minutes long was observed when depression screening was documented.

Conclusions: Depression screening may increase the duration of physician visits. Given demands on physicians' time, the impact of increased depression screening, including the costs and benefits of using alternative methods and technologies to reduce physician time burden associated with depression screening, should be evaluated.