Association between Practice Participation in a Pediatric-focused Medical Home Learning Collaborative and Reduction of Preventable Emergency Department Visits by Publicly-insured Children in Massachusetts
| Autor: | Valerie Konar, Anna L Christensen, Louise Bannister, Paul B Kirby |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Medical home
medicine.medical_specialty business.industry MEDLINE Multi-institutional collaborative and QI network research Collaborative learning Emergency department 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Family medicine Intervention (counseling) medicine 030212 general & internal medicine Location business Association (psychology) Medicaid |
| Zdroj: | Pediatric Quality & Safety |
| ISSN: | 2472-0054 |
| Popis: | Introduction This study evaluates the impact of practice participation in a pediatric patient-centered medical home learning collaborative on preventable emergency department (ED) visits among children in MassHealth (Massachusetts Medicaid/Children's Health Insurance Program). Methods Claims and enrollment data were extracted for child MassHealth members (aged 3-18) comprising 2 groups: members enrolled in a group of 13 child-serving practices that participated in an intensive, 29-month long patient-centered medical home learning collaborative (intervention group), and members enrolled in a group of 12 comparison practices with roughly similar panel size, type, and geographic location (comparison group). Preventable ED visits were identified using a modified version of the New York University ED algorithm. Two analyses were then conducted: (1) a repeat cross-sectional analysis among children enrolled in intervention or comparison group practices during baseline (first half of 2011) and follow-up (second half of 2013) periods; and (2) a longitudinal analysis among a subset of children enrolled for the full study period (2011-2013). Both analyses tested whether the effect of the intervention differed for children with versus without chronic conditions (effect modification). Results Preventable ED visits declined from baseline to follow-up among children in both intervention and comparison practices. In the cross-sectional analysis, the decrease was the same in both practice groups, and for children with versus without chronic conditions. The longitudinal analysis shows a statistically significantly greater decrease among children with chronic conditions enrolled in the intervention practices (P = 0.02). Conclusion Children with chronic conditions might receive the greatest benefit from receiving care in a medical home setting. |
| Databáze: | OpenAIRE |
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