”The patient-centered medical home has emerged as an innovative health care delivery model that holds the conceptual promise to improve healthcare quality while reducing costs,” says Dr. Haichang Xin, research associate in the department of health care organization and policy at the University of Alabama at Birmingham. In collaboration with department colleagues Dr. Meredith L. Kilgore, professor and chair, and Dr. Bisakha Sen, professor — as well as Dr. Nir Menachemi, formerly at UAB and currently at Indiana University — Dr. Xin conducted a retrospective cohort study that determined how patients’ perception of patient-centered medical homes relate to the use of and costs for emergency department and inpatient care across the United States.
Evaluating data from the 2007–2010 Medical Expenditure Panel Survey and focusing on 15,595 insured individuals ages 18 and older — representing 368 million Americans — the researchers analyzed 1) a full patient-centered medical home group; 2) a partial patient-centered medical home group; and 3) an unknown patient-centered medical home group, controlling for covariates at baseline and using negative binomial regression and generalized linear models. Study results show that “the trend of outcome changes from the baseline to the follow-up year, the full and partial patient-centered medical home groups demonstrated reduced efficiency for the 2007–2008 cohort, but increased efficiency for the 2009–2010 cohort, as compared to the no regular provider group.”
Dr. Xin concludes, “Overall, the empirical evidence does not indicate whether patient-centered medical home models reduce healthcare utilization and costs, but it does suggest their potential as mechanisms for achieving healthcare system efficiency, when primary care practices have grown from early to middle stage of patient-centered medical home transformation. A longer observation window and holistic view on all stages of patient-centered medical home growth may be more informative on patient-centered medical home’s efficiency.”
“The Relationships between Access to and Use of a Patient–Centered Medical Home and Healthcare Utilization and Costs: A Cohort Study Using Medical Expenditure Panel Survey Data from 2007 to 2010” was published online in September in the journal Health Services Management Research.