Document Detail


Quality and equity of primary care with patient-centered medical homes: results from a national survey.
MedLine Citation:
PMID:  23047125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The patient-centered medical home (PCMH) model has gained support, but the impact of this model on the quality and equity of care merits further evaluation.
OBJECTIVE: To determine if PCMHs are associated with improved quality and equity in pediatric primary care.
RESEARCH DESIGN: Using the 2007/2008 National Survey of Children's Health, a nationally representative survey of parents/guardians of children (age, 0-17 y), we evaluated the association of PCMHs with 10 quality-of-care measures using multivariable regression models, adjusting for demographic and socioeconomic covariates. For quality indicators that were significantly associated with medical homes, we determined if this association differed by race/ethnicity.
RESULTS: Compared with children without medical homes, those with medical homes had significantly better adjusted rates for 6 of 10 quality measures (all P≤0.02), such as obtaining a developmental history [adjusted rates % (SE): 41.7 (1.3) vs. 52.0 (1.1), P<0.001]. Having a medical home was associated with better adjusted rates of receiving a developmental history exam for both white and black children, but the disparity between these groups was not significantly narrowed [difference in risk differences (SE): 0.9 (4.3) for whites vs. blacks; P=0.83].
CONCLUSIONS: Our results underscore the benefits of the medical home model for children while highlighting areas for improvement, such as narrowing disparities. Our findings also emphasize the key role of patient experience measures in the evaluation of medical homes.
Authors:
Jaya Aysola; Asaf Bitton; Alan M Zaslavsky; John Z Ayanian
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Medical care     Volume:  51     ISSN:  1537-1948     ISO Abbreviation:  Med Care     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-20     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0230027     Medline TA:  Med Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  68-77     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child Health Services / statistics & numerical data
Child, Preschool
Female
Healthcare Disparities / statistics & numerical data*
Humans
Infant
Infant, Newborn
Male
Patient-Centered Care / statistics & numerical data*
Preventive Health Services / statistics & numerical data
Primary Health Care / statistics & numerical data*
Quality Indicators, Health Care / statistics & numerical data
Quality of Health Care / statistics & numerical data*
Socioeconomic Factors
United States
Grant Support
ID/Acronym/Agency:
T32HP10251//PHS HHS; UL1 RR 025758/RR/NCRR NIH HHS; UL1 RR025758/RR/NCRR NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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