Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.
J Prim Care Community Health
; 8(4): 192-197, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-29161972
ABSTRACT
OBJECTIVE:
Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida.METHODS:
We used de-identified, longitudinal electronic health record (EHR) data from 2010-2012 and multivariate logistic regression to analyze the effects of initial transformation on the odds of having well-controlled HbA1c, body mass index (BMI), and blood pressure (BP) among vulnerable patients with diabetes. Models controlled for clustering by year, patient, and organizational characteristics.RESULTS:
Overall, transformation to a PCMH was associated with 19% greater odds of having well-controlled HbA1c values with no statistically significant impact on BMI or BP. Subanalyses showed transformation had less of an effect on BP for African American patients and HbA1c control for Medicare enrollees but a greater effect on weight control for patients older than 35 years.CONCLUSION:
Transformation to a PCMH in FQHCs appears to improve the health of vulnerable patients with diabetes, with less improvement for subsets of patients. Future research should seek to understand the heterogeneous effects of patient-centered transformation on various subgroups.Palavras-chave
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
Bases de dados:
MEDLINE
Assunto principal:
Centros Comunitários de Saúde
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Assistência Centrada no Paciente
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Atenção à Saúde
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Diabetes Mellitus
Tipo de estudo:
Observational_studies
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Prognostic_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Prim Care Community Health
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos