Adjusting Antidepressant Quality Measures for Race and Ethnicity.

Adjusting Antidepressant QualityMeasures for Race and Ethnicity Increasing awareness of health care disparities has prompted reexamination of the National Quality Forum recommendation that measures of health care quality not be adjusted for patients’ sociodemographic characteristics.Adjustmentmight appear to endorse poorer-quality care for those traditionally underserved. However, Fiscella and colleagues1 pointed out that failure to adjust for sociodemographic differencesmight unfairlypenalizehealthsystemsservingdisadvantagedgroups. Jha and Zaslavsky2 argued that quality measures should be adjusted for patient characteristics when differences between health systems are confounded by differences between the patients they serve. In those cases, stratified reporting of quality measures would both reveal health disparities and permit fairer comparisons of quality across health systems or facilities. Given that rates of mental health treatment differ markedly by race and ethnicity,3 this cohort study examined how stratifying by race/ethnicity would affect a specific mental healthcarequalitymeasure: theproportionofoutpatientsstarting antidepressant treatmentwho receive adequate or potentially effective acute-phase treatment.4