Do Patient‐Centered Medical Homes Improve Health Behaviors, Outcomes, and Experiences of Low‐Income Patients? A Systematic Review and Meta‐Analysis. (3rd July 2017)

• Record Type: Journal Article
• Authors: van den Berk‐Clark, Carissa; Doucette, Emily; Rottnek, Fred; Manard, William; Prada, Mayra Aragon; Hughes, Rachel; Lawrence, Tyler; Schneider, F. David
• Is Part Of: Health services research. Volume 53:Number 3(2018)
• Page Start: 1777
• Page End: 1798
• Publication Date: 2017-07-03
• Subjects: Patient‐centered medical home -- underserved patients -- poverty -- implementation; Medical care -- Periodicals; Medical care -- Evaluation -- Periodicals; Hospital care -- Periodicals; Health services administration -- Periodicals; 362
• DOI: 10.1111/1475-6773.12737
• Languages: English
• ISSNs: 0017-9124

Abstract

Abstract : 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.