TY - JOUR
AU - J. Aysola
AU - A. Bitton
AU - A. M. Zaslavsky
AU - J. Z. Ayanian
A1 - 
AB - BACKGROUND: : The patient-centered medical home (PCMH) model has gained support, but the impact of this model on the quality and equity of care merits further evaluation. OBJECTIVE: : To determine if PCMHs are associated with improved quality and equity in pediatric primary care. RESEARCH DESIGN: : Using the 2007/2008 National Survey of Children's Health, a nationally representative survey of parents/guardians of children (age, 0-17 y), we evaluated the association of PCMHs with 10 quality-of-care measures using multivariable regression models, adjusting for demographic and socioeconomic covariates. For quality indicators that were significantly associated with medical homes, we determined if this association differed by race/ethnicity. RESULTS: : Compared with children without medical homes, those with medical homes had significantly better adjusted rates for 6 of 10 quality measures (all P</=0.02), such as obtaining a developmental history [adjusted rates % (SE): 41.7 (1.3) vs. 52.0 (1.1), P<0.001]. Having a medical home was associated with better adjusted rates of receiving a developmental history exam for both white and black children, but the disparity between these groups was not significantly narrowed [difference in risk differences (SE): 0.9 (4.3) for whites vs. blacks; P=0.83]. CONCLUSIONS: : Our results underscore the benefits of the medical home model for children while highlighting areas for improvement, such as narrowing disparities. Our findings also emphasize the key role of patient experience measures in the evaluation of medical homes.
BT - Medical care
C5 - Medical Home
CP - 1
CY - United States
DO - 10.1097/MLR.0b013e318270bb0d
IS - 1
JF - Medical care
N2 - BACKGROUND: : The patient-centered medical home (PCMH) model has gained support, but the impact of this model on the quality and equity of care merits further evaluation. OBJECTIVE: : To determine if PCMHs are associated with improved quality and equity in pediatric primary care. RESEARCH DESIGN: : Using the 2007/2008 National Survey of Children's Health, a nationally representative survey of parents/guardians of children (age, 0-17 y), we evaluated the association of PCMHs with 10 quality-of-care measures using multivariable regression models, adjusting for demographic and socioeconomic covariates. For quality indicators that were significantly associated with medical homes, we determined if this association differed by race/ethnicity. RESULTS: : Compared with children without medical homes, those with medical homes had significantly better adjusted rates for 6 of 10 quality measures (all P</=0.02), such as obtaining a developmental history [adjusted rates % (SE): 41.7 (1.3) vs. 52.0 (1.1), P<0.001]. Having a medical home was associated with better adjusted rates of receiving a developmental history exam for both white and black children, but the disparity between these groups was not significantly narrowed [difference in risk differences (SE): 0.9 (4.3) for whites vs. blacks; P=0.83]. CONCLUSIONS: : Our results underscore the benefits of the medical home model for children while highlighting areas for improvement, such as narrowing disparities. Our findings also emphasize the key role of patient experience measures in the evaluation of medical homes.
PP - United States
PY - 2013
SN - 1537-1948; 0025-7079
SP - 68
EP - 77
EP - 
T1 - Quality and equity of primary care with patient-centered medical homes: results from a national survey
T2 - Medical care
TI - Quality and equity of primary care with patient-centered medical homes: results from a national survey
U1 - Medical Home
U2 - 23047125
U3 - 10.1097/MLR.0b013e318270bb0d
VL - 51
VO - 1537-1948; 0025-7079
Y1 - 2013
ER -