Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.

未参保人群的治疗投入不佳，接受抑郁症循证干预的可能性较小。本研究的目的是回顾性检查初级保健中未投保患者的抑郁症筛查，诊断和治疗方式。研究样本包括所有患者（N  = 11,803）在九个社区诊所中看到。关键变量包括抑郁症筛查和/或抑郁症诊断，抗抑郁药启动，行为健康就诊以及患者随访措施。通过收集诊断后六个月（180天）的行为健康就诊次数和抗抑郁药使用量，分析了被诊断为抑郁症患者的子样本的治疗方式。抑郁筛查工具的使用率很高（67％，n  =  7,935），其中24％（n  =  2,789）的患者被诊断出患有抑郁症，但是，一半以上患有抑郁症的患者没有记录治疗计划（n  = 1,474）。西班牙裔患者使用抗抑郁药和进行行为探访的几率明显高于非西班牙裔患者。在初级保健中采用简短措施进行的普查工作正在改善，但是，对于没有保险的人群，指南一致的抑郁症治疗仍然遥遥无期。