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Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.

Title: Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida.
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Name(s): Kinsell, Heidi S, author
Hall, Allyson G, author
Harman, Jeffrey S, author
Tewary, Sweta, author
Brickman, Andrew, author
Type of Resource: text
Genre: Journal Article
Text
Date Issued: 2017-10-01
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida. We used de-identified, longitudinal electronic health record (EHR) data from 2010-2012 and multivariate logistic regression to analyze the effects of initial transformation on the odds of having well-controlled HbA1c, body mass index (BMI), and blood pressure (BP) among vulnerable patients with diabetes. Models controlled for clustering by year, patient, and organizational characteristics. Overall, transformation to a PCMH was associated with 19% greater odds of having well-controlled HbA1c values with no statistically significant impact on BMI or BP. Subanalyses showed transformation had less of an effect on BP for African American patients and HbA1c control for Medicare enrollees but a greater effect on weight control for patients older than 35 years. Transformation to a PCMH in FQHCs appears to improve the health of vulnerable patients with diabetes, with less improvement for subsets of patients. Future research should seek to understand the heterogeneous effects of patient-centered transformation on various subgroups.
Identifier: FSU_pmch_29161972 (IID), 10.1177/2150131917742300 (DOI), PMC5932745 (PMCID), 29161972 (RID), 29161972 (EID)
Keywords: Access to care, Community health centers, Disease management, Health outcomes, Impact evaluation, Patient-centeredness, Primary care
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5932745.
Subject(s): Adult
African Americans
Age Factors
Aged
Blood Preservation
Body Mass Index
Community Health Centers/organization & administration
Delivery of Health Care/organization & administration
Diabetes Mellitus/metabolism
Diabetes Mellitus/therapy
European Continental Ancestry Group
Female
Florida
Glycated Hemoglobin A/metabolism
Hispanic Americans
Humans
Logistic Models
Longitudinal Studies
Male
Medicare
Middle Aged
Multivariate Analysis
Outcome Assessment (Health Care)
Patient-Centered Care/organization & administration
Quality of Health Care
United States
Vulnerable Populations
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_pmch_29161972
Host Institution: FSU
Is Part Of: Journal of primary care & community health.
2150-1327
Issue: iss. 4, vol. 8

Choose the citation style.
Kinsell, H. S., Hall, A. G., Harman, J. S., Tewary, S., & Brickman, A. (2017). Impacts of Initial Transformation to a Patient-Centered Medical Home on Diabetes Outcomes in Federally Qualified Health Centers in Florida. Journal Of Primary Care & Community Health. Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_29161972