Patient-centered medical home care access among adults with chronic conditions: National Estimates from the medical expenditure panel survey.

Autor: Almalki ZS; Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia. z.almalki@psau.edu.sa., Karami NA; Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia., Almsoudi IA; Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia., Alhasoun RK; College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia., Mahdi AT; Department of Pharmaceutical Science, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia., Alabsi EA; Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia., Alshahrani SM; Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia., Alkhdhran ND; College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia., Alotaib TM; College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: BMC health services research [BMC Health Serv Res] 2018 Sep 27; Vol. 18 (1), pp. 744. Date of Electronic Publication: 2018 Sep 27.
DOI: 10.1186/s12913-018-3554-3
Abstrakt: Background: The Patient-Centered Medical Home (PCMH) model is a coordinated-care model that has served as a means to improve several chronic disease outcomes and reduce management costs. However, access to PCMH has not been explored among adults suffering from chronic conditions in the United States. Therefore, the aim of this study was to describe the changes in receiving PCMH among adults suffering from chronic conditions that occurred from 2010 through 2015 and to identify predisposing, enabling, and need factors associated with receiving a PCMH.
Methods: A cross-sectional analysis was conducted for adults with chronic conditions, using data from the 2010-2015 Medical Expenditure Panel Surveys (MEPS). Most common chronic conditions in the United States were identified by using the most recent data published by the Agency for Healthcare Research and Quality (AHRQ). The definition established by the AHRQ was used as the basis to determine whether respondents had access to PCMH. Multivariate logistic regression analyses were conducted to detect the association between the different variables and access to PCMH care.
Results: A total of 20,403 patients with chronic conditions were identified, representing 213.7 million U.S. lives. Approximately 19.7% of the patients were categorized as the PCMH group at baseline who met all the PCMH criteria defined in this paper. Overall, the percentage of adults with chronic conditions who received a PCMH decreased from 22.3% in 2010 to 17.8% in 2015. The multivariate analyses revealed that several subgroups, including individuals aged 66 and older, separated, insured by public insurance or uninsured, from low-income families, residing in the South or the West, and with poor health, were less likely to have access to PCMH.
Conclusion: Our findings showed strong insufficiencies in access to a PCMH between 2010 and 2015, potentially driven by many factors. Thus, more resources and efforts need to be devoted to reducing the barriers to PCMH care which may improve the overall health of Americans with chronic conditions.
Databáze: MEDLINE
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