Research Activities, May 2013
Patient-centered medical homes cost-effectively improve patient experience and quality of care for seniors
Elderly Health/Long-Term Care
Older patients who received primary care at a patient-centered medical home (PCMH) reported significantly better experiences in shared decisionmaking a year later, and in coordination of care and access to care both 12 and 24 months later than did similar patients at two control clinics, according to a new study.
The PCMH care model was originally developed to provide better coordinated, family-oriented care for children with special needs. More recently, it has been expanded to provide patients of all ages with primary care that emphasizes long-term relationships between physicians and patients.
The researchers used data from a large regional integrated health system’s pilot study that compared a primary care clinic converted to the PCMH model with two control clinics. In addition to the results in terms of patient experience, the researchers also compared care quality at the PCMH clinic with quality of care at the system’s other 19 primary care clinics.
They found that clinical quality on 22 measures improved for patients over 65 years old over baseline for the PCMH at 12 and 24 months, but did not differ significantly between the pilot clinic and the 19 control clinics. PCMH patients used more Email, phone, and specialist visits, but fewer emergency services and inpatient admissions for ambulatory care-sensitive conditions. At 1 and 2 years, the PCMH and control clinics did not differ significantly in overall costs. The study was funded in part by AHRQ (HS19129).
More details are in "Impact on seniors of the patient-centered medical home: Evidence from a pilot study," by Paul A. Fishman, Ph.D., Eric A. Johnson, M.S., Kathryn Coleman, M.S.P.H., and others in the October 2012 The Gerontologist 52(5), pp. 703-711.