2021 article

Duration of medical home participation and quality of care for patients with chronic conditions

Swietek, K. E., Domino, M. E., Grove, L. R., Beadles, C., Ellis, A. R., Farley, J. F., … DuBard, C. A. (2021, August 17). HEALTH SERVICES RESEARCH.

author keywords: depression; medical homes; multiple chronic conditions; quality of care
MeSH headings : Adult; Depressive Disorder, Major / therapy; Female; Hospitalization / statistics & numerical data; Humans; Male; Medicaid / statistics & numerical data; Mental Health Services / statistics & numerical data; Middle Aged; Multiple Chronic Conditions / therapy; North Carolina; Patient-Centered Care / statistics & numerical data; Quality of Health Care / statistics & numerical data; Retrospective Studies; United States
TL;DR: The PCMH model is associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increase the longer a patient is enrolled. (via Semantic Scholar)
UN Sustainable Development Goal Categories
Source: Web Of Science
Added: August 30, 2021

AbstractObjectiveTo examine whether the length of participation in a patient‐centered medical home (PCMH), an evidence‐based practice, leads to higher quality care for Medicaid enrollees with multiple co‐morbid chronic conditions and major depressive disorder (MDD).Data SourcesThis analysis uses a unique data source that links North Carolina Medicaid claims and enrollment data with other administrative data including electronic records of state‐funded mental health services, a state psychiatric hospital utilization database, and electronic records from a five‐county behavioral health carve‐out program.Study DesignThis retrospective cohort study uses generalized estimating equations (GEEs) on person‐year‐level observations to examine the association between the duration of PCMH participation and measures of guideline‐concordant care, including the receipt of minimally adequate care for MDD, defined as 6 months of antidepressant use or eight psychotherapy visits each year.Data Collection/Extraction MethodsAdults with two or more chronic conditions reflected in administrative data, including MDD.Principal FindingsWe found a 1.7 percentage point increase in the likelihood of receiving guideline‐concordant care at 4 months of PCMH participation, as compared to newly enrolled individuals with a single month of participation (p < 0.05). This effect increased with each additional month of PCMH participation; 12 months of participation was associated with a 19.1 percentage point increase in the likelihood of receiving guideline‐concordant care over a single month of participation (p < 0.01).ConclusionsThe PCMH model is associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increase the longer a patient is enrolled. Providers and policy makers should consider the positive effect of increased contact with PCMHs when designing and evaluating initiatives to improve care for this population.