Do Patient-Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low-Income Patients? A Systematic Review and Meta-Analysis
| Autor: | Tyler Lawrence, Rachel Hughes, M.S.W. Carissa van den Berk-Clark Ph.D., William Manard, Emily Doucette, M.S.P.H. F. David Schneider M.D., Fred Rottnek, Mayra Aragon Prada |
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| Rok vydání: | 2017 |
| Předmět: |
Medical home
medicine.medical_specialty Health Status media_common.quotation_subject Health Behavior Patient Experience and Patient‐Centered Care Psychological intervention 03 medical and health sciences 0302 clinical medicine Patient-Centered Care Health care medicine Humans Quality (business) 030212 general & internal medicine Poverty media_common Medically Uninsured Data collection business.industry 030503 health policy & services Health Policy Confounding Mental Health Treatment Outcome Patient Satisfaction Family medicine Meta-analysis Chronic Disease Patient Compliance Health Services Research Emergency Service Hospital 0305 other medical science business |
| Zdroj: | Health Services Research. 53:1777-1798 |
| ISSN: | 0017-9124 |
| DOI: | 10.1111/1475-6773.12737 |
| Popis: | Objectives To examine: (1) what elements of patient-centered medical homes (PCMHs) are typically provided to low-income populations, (2) whether PCMHs improve health behaviors, experiences, and outcomes for low-income groups. Data Sources/Study Setting Existing literature on PCMH utilization among health care organizations serving low-income populations. Study Design Systematic review and meta-analysis. Data Collection/Extraction Methods We obtained papers through existing systematic and literature reviews and via PubMed, Web of Science, and the TRIP databases, which examined PCMHs serving low-income populations. A total of 434 studies were reviewed. Thirty-three articles met eligibility criteria. Principal Findings Patient-centered medical home interventions usually were composed of five of the six recommended components. Overall positive effect of PCMH interventions was d = 0.247 (range −0.965 to 1.42). PCMH patients had better clinical outcomes (d = 0.395), higher adherence (0.392), and lower utilization of emergency rooms (d = −0.248), but there were apparent limitations in study quality. Conclusions Evidence shows that the PCMH model can increase health outcomes among low-income populations. However, limitations to quality include no assessment for confounding variables. Implications are discussed. |
| Databáze: | OpenAIRE |
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