Quality and Equity of Primary Care With Patient-Centered Medical Homes

Results From a National Survey

Bibliographic Data

ID9101623
AuthorsJaya Aysola (0000-0002-8474-3682, Harvard University, corresponding author), Asaf Bitton (0000-0002-3633-3806, Brigham and Women's Hospital, corresponding author), Alan M Zaslavsky (0000-0003-1072-6043, Harvard University, corresponding author), John Z Ayanian (Harvard University, corresponding author)
Year2013
Volume51
Issue1
Pages68-77
Publication date2013-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e318270bb0d
PMID23047125
PMCIDPMC3766903
OpenAlexW2024821265
LanguageEN
Citations received10
References cited31

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

Environmental health · Equity (law) · Ethnic group · Family medicine · Health care · Health equity · Medical care · Medical history · Medical home · Primary care · Public health · Socioeconomic status · Chronic Disease Management Strategies · Demography · Healthcare Policy and Management · Medicine · Nursing · Primary Care and Health Outcomes · Gerontology

Tools

Open DOISci-HubOpen Access