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Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.
| Title: | Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida. |
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| Name(s): |
Kinsell, Heidi S, author Hall, Allyson G, author Harman, Jeffrey S, author Tewary, Sweta, author Brickman, Andrew, author |
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| Type of Resource: | text | |
| Genre: |
Journal Article Text |
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| Date Issued: | 2017-10-01 | |
| Physical Form: |
computer online resource |
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| Extent: | 1 online resource | |
| Language(s): | English | |
| Abstract/Description: | 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. 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. 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. 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. | |
| Identifier: | FSU_pmch_29161972 (IID), 10.1177/2150131917742300 (DOI), PMC5932745 (PMCID), 29161972 (RID), 29161972 (EID) | |
| Keywords: | Access to care, Community health centers, Disease management, Health outcomes, Impact evaluation, Patient-centeredness, Primary care | |
| Publication Note: | This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932745. | |
| Subject(s): |
Adult African Americans Age Factors Aged Blood Preservation Body Mass Index Community Health Centers/organization & administration Delivery of Health Care/organization & administration Diabetes Mellitus/metabolism Diabetes Mellitus/therapy European Continental Ancestry Group Female Florida Glycated Hemoglobin A/metabolism Hispanic Americans Humans Logistic Models Longitudinal Studies Male Medicare Middle Aged Multivariate Analysis Outcome Assessment (Health Care) Patient-Centered Care/organization & administration Quality of Health Care United States Vulnerable Populations |
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| Persistent Link to This Record: | http://purl.flvc.org/fsu/fd/FSU_pmch_29161972 | |
| Host Institution: | FSU | |
| Is Part Of: |
Journal of primary care & community health. 2150-1327 |
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| Issue: | iss. 4, vol. 8 |
Kinsell, H. S., Hall, A. G., Harman, J. S., Tewary, S., & Brickman, A. (2017). Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida. Journal Of Primary Care & Community Health. Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_29161972
