TY - JOUR
T1 - Do Patient-Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low-Income Patients? A Systematic Review and Meta-Analysis
AU - van den Berk-Clark, Carissa
AU - Doucette, Emily
AU - Rottnek, Fred
AU - Manard, William
AU - Prada, Mayra Aragon
AU - Hughes, Rachel
AU - Lawrence, Tyler
AU - Schneider, F. David
N1 - Publisher Copyright:
© Health Research and Educational Trust
PY - 2018/6
Y1 - 2018/6
N2 - 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.
AB - 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.
KW - Patient-centered medical home
KW - implementation
KW - poverty
KW - underserved patients
UR - http://www.scopus.com/inward/record.url?scp=85021723715&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85021723715&partnerID=8YFLogxK
U2 - 10.1111/1475-6773.12737
DO - 10.1111/1475-6773.12737
M3 - Article
C2 - 28670708
AN - SCOPUS:85021723715
SN - 0017-9124
VL - 53
SP - 1777
EP - 1798
JO - Health Services Research
JF - Health Services Research
IS - 3
ER -