Thomas Croghan

Thomas W. Croghan, MD
Senior Fellow 
Mathematica Policy Research, Inc. 
600 Maryland Avenue S.W. #500 
Washington, DC 20024-2512 
Phone: (202) 554-7532 
Fax: (202) 484-3915 
tcroghan@mathematica-mpr.com

 

Research Interests:

Access, quality, and affordability of mental health services; mental health policy; pharmaceutical policy; and international health.

Research Summary:

My research focuses on access, quality, and affordability of treatments for depression in primary care. In general, this work has shown that, public policies such as the Americans with Disabilities Act appear to impose costly barriers for people with depressive disorders and for their employers (Croghan et al 1999).

Public knowledge and attitudes about psychiatric medications also appear to affect decisions to use these medications (Croghan et al. 2003). Using data from the 1998 General Social Survey, we have shown that Americans have a sophisticated understanding of the uses, effectiveness, and side effects of psychiatric medications in general and Prozac in particular, yet remain reluctant to use them.

We have also shown that the initial provider affects decisions to initiate treatment and whether any follow-up care is provided (Kniesner et al. 2003). However, once treatment is initiated, the total amount of both psychotherapy and medication appears to be independent of the provider at the time of entry into treatment. (Powers et al 2002).

Based on pharmacy claims data, it appears that the class of antidepressant is associated with the duration of treatment (Croghan et al. 1997; Tai-Seale et al. 2000), but no single SSRI is associated with greater likelihood of guideline-concordant care (Tai-Seale et al. 2000). Utilization review and other methods of cost-containment do not appear to affect population measures of quality after adjusting for case mix and other factors (Tai-Seale et al. 2000; Powers et al. 2002).

Representative Publications:
  • T.W. Croghan, C.D. Sherbourne, M. Schoenbaum, P. Koegel. A Framework to Improve the Quality of Care for Depression in Primary Care. Psychiatric Services, in press
  • J.A. Schnittker, B.A. Pescosolido, and T.W. Croghan. Are African Americans Really Less Willing to Use Health care? Social Problems 52(2): 255-271, 2005
  • T.W. Croghan, M. Tomlin, B. A. Pescosolido, J. Martin, K. Lubell, and R. Swindle. Americans' Knowledge and Attitudes Towards and Their Willingness to Use Psychiatric Medications. Journal of Nervous and Mental Disorders 191(3):166-174, 2003.
  • T.W. Croghan. The Controversy of Increased Spending for Antidepressants. Health Affairs 20 (no. 2): 129-135, 2001.
  • M.R. DiMatteo, H.S. Lepper, and T.W. Croghan. Depression is a Risk Factor for Noncompliance with Medical Treatment: Results of a Meta-Analysis of Effects of Anxiety and Depression on Patient Adherence. Archives of Internal Medicine 160:2101-2107, 2000